Hopkins Syndrome: An Uncommon Cause of Weakness in Intensive Care Unit

Hopkins syndrome is a rare polio-like syndrome, with an incompletely understood pathophysiology, that affects children after asthma crisis.

A 10-year-old girl was admitted to the intensive care unit following a severe asthma attack, requiring mechanical ventilation for a period of five days. After regaining consciousness, the patient exhibited development of asymmetric flaccid paraparesis. Neuroaxis magnetic resonance imaging revealed contrast enhancement in the anterior lumbar roots, with the enhancement originating at the T11 level and extending downward on axial series. Nerve conduction study revealed the absence of compound muscle action potentials in the tibialis and peroneal nerves on the left, with preserved sensory nerve action potentials.

Based on the patient's clinical phenotype, which was most consistent with a polio-like syndrome arising acutely following an asthmatic crisis, the diagnosis of Hopkins syndrome was established.

Hopkins syndrome is a rare polio-like syndrome that is probably underdiagnosed and has a poor motor prognosis.