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Mielitis flácida aguda de etiología desconocida en California, 2012-2015
Keith Van Haren1, Patrick Ayscue2, Emmanuelle Waubant3
1Department of Neurology, Stanford University School of Medicine, Stanford, California2Division of Child Neurology, Lucile Packard Children's Hospital, Stanford, California.
JAMA
|January 1, 2016
Resumen
Los casos de parálisis flácida aguda en California, que afectan principalmente a niños y adultos jóvenes, mostraron debilidad motora prolongada. Si bien se detectaron enterovirus, la causa exacta de este raro síndrome neurológico sigue sin determinarse.
Área de la Ciencia:
- Neurología
- Enfermedades infecciosas
- Vigilancia de la salud pública
Sus antecedentes:
- Existe una vigilancia limitada para la parálisis flácida aguda (AFP) en América del Norte después de la erradicación del poliovirus.
- California informó un aumento en los casos de AFP de etiología desconocida a partir de 2012.
Objetivo del estudio:
- Para determinar la incidencia de AFP con lesiones de las neuronas motoras espinales.
- Para identificar las posibles causas de estos casos de AFP.
Principales métodos:
- Se utilizó un enfoque de serie de casos para pacientes con AFP con afectación de las neuronas motoras espinales (evidencia radiológica/ neurofisiológica).
- Datos recopilados de junio de 2012 a julio de 2015 en California.
- Pruebas de laboratorio de muestras de líquido cefalorraquídeo, suero y vías respiratorias y heces para detectar agentes infecciosos.
Principales resultados:
- 59 casos de AFP identificados; edad media de 9 años, predominantemente niños y adultos jóvenes.
- La resonancia magnética reveló hiperintensidad de la materia gris de la médula espinal T2 en 56 pacientes; 43 tenían pleocitosis del líquido cefalorraquídeo.
- Los enterovirus fueron el patógeno más común detectado (15/45), particularmente durante un brote de Enterovirus D68. En el seguimiento se observó debilidad persistente en 38/45 pacientes.
Conclusiones:
- Se observó un síndrome raro pero distinto de AFP con lesión de la neurona motora espinal en California.
- La etiología sigue siendo indeterminada, afectando principalmente a niños y adultos jóvenes con debilidad motora prolongada.
- Se necesitan más investigaciones para aclarar las causas de esta condición neurológica.
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