BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 69, Issue 8 (August 2017)

An Adult Case of Enterovirus D68 Encephalomyelitis Presenting as Bilateral Facial Nerve Palsy and Dysphagia Yuta Kusabe 1,2 , Akari Takeshima 1 , Azusa Seino 1 , Mana Nishida 1 , Mami Takahashi 1 , Shota Yamada 1 , Junsuke Shimbo 1 , Aki Sato 1 , Kouichirou Okamoto 3 , Shuichi Igarashi 1 1Department of Neurology, Niigata City General Hospital 2Section of Medical Education and Training, Niigata City General Hospital 3Brain Research Institute, Niigata University Keyword: エンテロウイルスD68 , 脳脊髄炎 , 両側顔面神経麻痺 , 嚥下障害 , MRI , enterovirus D68 , encephalomyelitis , bilateral facial nerve palsy , dysphagia , MRI pp.957-961
Published Date 2017/8/1
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A 33-year-old man was admitted to our hospital with bilateral facial nerve paralysis, dysphagia, and muscle weakness in the neck and trunk following fever, headache and throat pain. T2-weighted brain magnetic resonance imaging (MRI) showed hyperintense lesions in the tegmentum of the brain stem and the ventral region of the superior cervical cord. Based on the characteristic findings on the brain MRI, we diagnosed the patient with enteroviral encephalomyelitis. Steroid therapy was administered; however, his bilateral facial nerve paralysis and dysphagia were refractory to this therapy. Subsequently, enterovirus D68 was detected in the serum using polymerase chain reaction (PCR) analysis. At that time, an outbreak of enteroviral D68 infection was reported in Japan. Finally, we diagnosed encephalomyelitis caused by enteroviral D68 infection. Characteristic MRI findings were very useful in narrowing down the differential diagnosis in this patient.

(Received March 3, 2017; Accepted April 20, 2017; Published August 1, 2017)

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BRAIN and NERVE-神経研究の進歩
69巻8号 (2017年8月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院