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Continuous myocloni and tonic spasms in a 2-month-old infant with enterovirus 71 brain stem encephalitis

Kyung Yeon Lee1, Hye-Ryun Yeh2

  • 1Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

Neuropediatrics
|October 8, 2014
PubMed

Insights

Enterovirus 71 brain stem encephalitis can cause severe myoclonus and tonic spasms in infants. Prompt immunoglobulin therapy led to complete remission, suggesting the brain stem

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Enterovirus 71 (EV71) infection can lead to central nervous system (CNS) involvement.
  • Brain stem encephalitis is a recognized manifestation of EV71 infection, presenting with neurological deficits.

Observation:

  • A 2-month-old infant presented with continuous myoclonus and tonic spasms.
  • Symptoms worsened significantly, with myoclonic jerks occurring frequently and tonic spasms affecting all extremities.
  • Video electroencephalography showed no epileptiform activity during the episodes.

Findings:

  • The infant's symptoms were attributed to enterovirus 71 brain stem encephalitis.
  • Complete remission was achieved after a 3-day course of immunoglobulin therapy.
  • The brain stem is implicated as a potential origin for both myoclonus and tonic spasms in this context.

Implications:

  • This case highlights the potential severity of EV71-related brain stem encephalitis in infants.
  • It underscores the efficacy of immunoglobulin therapy in managing such neurological manifestations.
  • The findings suggest a critical role of the brain stem in the pathophysiology of these movement disorders during EV71 infection.

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