[Acute infantile hemiplegia caused by Coxsackie B virus]

Acute infantile hemiplegia (AIH) is a syndrome that appears, typically, in infants without any underlying neurological damage. It can be due to a number of causes, in which viral infections play an important role. We report a case of AIH caused by Coxsackie B virus.

A 20-month-old female who visited because of fever, vomiting and progressive left hemiparesis. Clinical exploration did not reveal any alteration in the level of consciousness and the only striking feature was the left hemiparesis, with weak deep muscle reflexes. Of the complementary examinations carried out, the most important were: LCR with 80 leukocytes/mm3 (predominance of mononuclear cells), EEG with a persistent focus in the right temporal region (which had become normal at four days) and a positive Coxsackie B virus serology. Progression was completely normal.

AIH is produced as a complication of focal encephalitis which gives rise to a vasculitic phenomenon. Among the infectious causes, one important aetiological agent is the herpes simplex virus. Enterovirus, however, are infrequent. Therefore, until the exact aetiology has been established, it appears wise to begin empirical therapy with acyclovir. When the germs involved in this entity are enterovirus, prognosis is good, although there are reports of cases involving neurological sequelae in the literature.