Limb paralysis as a manifestation of Coxsackie B virus infection

Forty-four African children (25 girls, 19 boys) are described with single or multiple limb paralysis as a manifestation of infection with Coxsackie B virus. Single limb paralysis involved exclusively the lower extremity, with no nervous system involvement elsewhere and a relatively benign prognosis. Multiple limb paralysis occurred either alone or with other neurological deficits. Only two of 15 patients followed up for five months or longer regained premorbid motor status. Seven patients required assisted ventilation, of whom all but one died. Viral infection remains an important cause of acute limb paralysis in this population, and Coxsackie B is the agent often responsible.