Severe Acute Flaccid Myelitis Associated With Enterovirus in Children: Two Phenotypes for Two Evolution Profiles?

Melodie Aubart (1, 2) , Cyril Gitiaux (3, 1) , Charles Joris Roux (1) , Raphael Levy (1) , Isabelle Schuffenecker (4) , Audrey Mirand (5) , Nathalie Bach , Florence Moulin (1) , Jean Bergounioux (6) , Marianne Leruez-Ville (1) , Flore Rozenberg (7) , Delphine Sterlin (8) , Lucile Musset (8) , Denise Antona , Nathalie Boddaert (3, 1) , Shen Ying Zhang (2) , Manoelle Kossorotoff (1) , Isabelle Desguerre (1)

1 Hôpital Necker - Enfants Malades [AP-HP]
2 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
3 IMRB - Institut Mondor de Recherche Biomédicale
4 Hôpital de la Croix-Rousse [CHU - HCL]
5 LMGE - Laboratoire Microorganismes : Génome et Environnement
6 Hôpital Raymond Poincaré [AP-HP]
7 Hôpital Cochin [AP-HP]
8 CHU Pitié-Salpêtrière [AP-HP]

Acute flaccid myelitis (AFM) is an acute paralysis syndrome defined by a specific inflammation of the anterior horn cells of the spinal cord. From 2014, worrying waves of life-threatening AFM consecutive to enterovirus infection (EV-D68 and EV-A71) have been reported. We describe 10 children displaying an AFM with an EV infection, the treatments performed and the 1 to 3-years follow-up. Two groups of patients were distinguished: 6 children (“polio-like group”) had severe motor disability whereas 4 other children (“brainstem group”) displayed severe brainstem weakness requiring ventilation support. Electrodiagnostic studies (n = 8) support the presence of a motor neuronopathy associated to myelitis. The best prognosis factor seems to be the motor recovery after the first 4 weeks of the disease.

Mots clés: enterovirus; myelitis; children; EV-D68; EV-A71

Domaines: Maladies infectieuses; Pédiatrie; Neurobiologie

Melodie Aubart, Cyril Gitiaux, Charles Joris Roux, Raphael Levy, Isabelle Schuffenecker, et al.. Severe Acute Flaccid Myelitis Associated With Enterovirus in Children: Two Phenotypes for Two Evolution Profiles?. Frontiers in Neurology, 2020, 11, pp.343. ⟨10.3389/fneur.2020.00343⟩. ⟨hal-02998679⟩