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• W1589700928 abstract "OBJECTIVE: The objective of this study is to report viral associations in a cluster of six children who presented with acute flaccid paralysis seen in a single tertiary level center and to describe response to acute therapy.BACKGROUND: Between August-September 2014, a cluster of children presented to North American centers with pure motor flaccid paresis. The viral associations, ideal treatment protocol and response to therapy have not been characterized, yet.<br DESIGN/METHOD: We evaluated prospectively collected data on children (Aug 15th-Sept 30th 2014) presenting to The Hospital for Sick Children who met Center for Disease Control (CDC) updated criteria for acute flaccid paralysis. Standardized rheumatologic and infectious disease investigation, and neuroimaging (MRI) were performed on all patients. Clinical course and treatment protocols were evaluated.RESULTS: Six children with acute flaccid paralysis were included (Female=2; median 5.5 years (range 2.5 years - 8.5 years)). The following characteristics were seen: Prodromal fever (5/6); CSF lymphocytic pleocytosis (5/6); MRI evidence of brainstem involvement (2/6), central grey matter spinal cord involvement (5/6), and ventral nerve root enhancement (6/6). Enterovirus/rhinovirus was detected by PCR in 4/6 children. Of these, three were identified as: enterovirus D68 (1/6), coxsackie B2 (1/6) and rhinovirus spp. (1/6). No organisms were isolated from the CSF in any patient. All patients showed some recovery of motor function after treatment with a standardized protocol of immunotherapy (methylprednisolone, IVIG, plasmapheresis).CONCLUSION: Although this group of phenotypically similar cases appeared in a cluster, no single infectious inciting agent was found. All subjects were 8 years old or younger. Recovery of some motor function was seen in all. However, whether this was spontaneous or in response to treatment, needs still to be determined. Larger multi-centre studies are needed to understand the ideal therapeutic modalities for this potentially devastating condition. Disclosure: Dr. Nabavi Nouri has nothing to disclose. Dr. Irwin has nothing to disclose. Dr. Richardson has nothing to disclose. Dr. Branson has nothing to disclose. Dr. licht has nothing to disclose. Dr. Hutchison has nothing to disclose. Dr. Bitnun has nothing to disclose. Dr. Yeh has nothing to disclose." @default.
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• W1589700928 date "2015-04-06" @default.
• W1589700928 modified "2023-09-22" @default.
• W1589700928 title "Acute Flaccid Paralysis in a Cluster of Six Children at The Hospital for Sick Children: August-September 2014. Toronto, ON. (P6.258)" @default.
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