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Enterovirus A-71 Associated Parainfectious Movement Disorders in Children.

Suus A M van Noort1,2, Jan Willem J Elting2,3, Thomas Foiadelli4

  • 1Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Movement Disorders Clinical Practice
|June 18, 2025
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Summary

Enterovirus A-71 (EV-A71) infection can cause pediatric movement disorders like myoclonus and ataxia. Early recognition aids diagnosis and management of these parainfectious conditions.

Keywords:
ataxiaenterovirusinfectionmovement disordermyoclonuspediatric

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Pediatric movement disorders present diagnostic challenges due to complex phenotypes and broad differentials.
  • Acquired causes, such as Enterovirus A-71 (EV-A71) rhombencephalitis, require specific diagnostic considerations beyond genetic testing.
  • EV-A71-associated rhombencephalitis is a known cause of movement disorders in children, necessitating improved recognition.

Observation:

  • Four pediatric patients (21 months–12 years) with movement disorders and confirmed EV-A71 infection were studied.
  • All patients exhibited myoclonus, with one also presenting ataxia.
  • Both focal and generalized myoclonus were observed, with polymyography indicating a subcortical origin.

Findings:

  • Movement disorders in these cases were directly linked to EV-A71 infection.
  • The observed movement disorders resolved as the infection improved.
  • Polymyography confirmed a subcortical origin for the myoclonus.

Implications:

  • Recognizing EV-A71 parainfectious movement disorders in children facilitates appropriate and cost-effective diagnostic approaches.
  • Suspected EV-A71 infections warrant PCR testing in stool and nasopharyngeal samples.
  • Neuroimaging and polymyography are valuable tools for supporting the diagnosis of EV-A71-associated movement disorders.