1. Acute Flaccid Paralysis as the Initial Manifestation of Japanese Encephalitis: a Case Report.
- Author
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Shen Q, Li Y, Lu H, Ning P, Huang H, Zhao Q, and Xu Y
- Subjects
- Acyclovir therapeutic use, Administration, Intravenous, Adult, Antibodies, Viral cerebrospinal fluid, Antiviral Agents therapeutic use, China, Encephalitis Virus, Japanese immunology, Encephalitis Virus, Japanese isolation & purification, Encephalitis, Japanese drug therapy, Humans, Immunoglobulin M cerebrospinal fluid, Male, Treatment Outcome, Central Nervous System Viral Diseases diagnosis, Central Nervous System Viral Diseases etiology, Encephalitis, Japanese complications, Encephalitis, Japanese diagnosis, Myelitis diagnosis, Myelitis etiology, Neuromuscular Diseases diagnosis, Neuromuscular Diseases etiology
- Abstract
Japanese encephalitis (JE) is a clinical disease caused by inflammation of the central nervous system. The symptoms of this disease range broadly in severity from mild febrile illness to acute meningomyeloencephalitis. JE has been associated with a variety of neurological abnormalities, such as altered sensorium, seizures, focal neurological deficit, and acute flaccid paralysis (AFP). However, to date, AFP has never been reported as an initial manifestation of JE. Here, we present a case of AFP manifesting as the initial symptom of JE in a Chinese patient. A 30-year-old Chinese man was admitted to the West China Hospital of Sichuan University after experiencing AFP in the right upper limb, followed by hyperpyrexia and unconsciousness. Assay of cerebrospinal fluid from a lumbar puncture revealed high levels of proteins and anti- JE virus IgM antibodies. Intravenous acyclovir was administered; however, the weakness persisted and more extensive muscle wasting from the proximal to distal right upper limb occurred over 7 months. This case report highlights that JE needs to be added to the differential diagnosis of AFP in adults, especially in JE endemic seasons and areas.
- Published
- 2020
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