Enterovirus A-71 Associated Parainfectious Movement Disorders in Children

Pediatric movement disorders can be challenging to characterize, given the phenotypic complexity and broad differential diagnosis. While genetic tests are often part of the diagnostic work-up, it is important to consider acquired causes, which may require specific investigations. Enterovirus A-71 (EV-A71) associated rhombencephalitis frequently presents with movement disorders. We aim to improve the recognition of these phenotypes.

We describe four patients (aged 21 months-12 years) presenting with movement disorders and a confirmed EV-A71 infection. All patients had myoclonus, one suffered from ataxia. Both focal arm flexion myoclonus and generalized myoclonus were observed. Polymyography demonstrated a subcortical origin. The movement disorders subsided with infection improvement.

Recognition of EV-A71 parainfectious movement disorders in childhood enables clinicians to obtain appropriate, cost-effective diagnostics. When an EV-A71 infection is suspected PCR-diagnostics in stool and nasopharynx material is required. Neuroimaging and polymyography can support the diagnosis.