Acute Cerebellar Ataxia in Children Associated With Infection by Poliovirus I

Méndez-Cashion, Dolores; Sanchez-Longo, Luis P.; Valcárcel, Marta; Rosen, Léon

doi:10.1542/peds.29.5.808

Cited by 14 publications

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“…Our study provides compelling in vivo evidence of cerebellar changes in adult poliomyelitis survivors with reference to healthy controls. In contrast to previous postmortem studies [9,14,15] and sporadic clinical reports [16][17][18], the cohort of adult poliomyelitis survivors evaluated in this study did not exhibit cerebellar atrophy. On the contrary, polio survivors exhibited hypertrophic changes in the cerebellum.…”

Section: Discussioncontrasting

confidence: 98%

“…Accounts of involvement of cerebellar cortical layers are strikingly conflicting [9,10,14,15]. Sporadic cerebellar manifestations, such as ataxia, nystagmus, vertigo and intention tremor had been linked to poliovirus type 1 [16][17][18]. The rarity of frank cerebellar findings was hypothesised to be due to limited cerebellar degeneration and the challenge of ascertaining cerebellar signs in the presence of widespread lower motor neuron degeneration [15].…”

Section: Introductionmentioning

confidence: 99%

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Cerebellar remodelling decades after spinal cord insult: neuroplasticity in poliomyelitis survivors

Shing¹,

Murad²,

Lope³

et al. 2022

J. Integr. Neurosci.

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Background:The cerebellum integrates a multitude of motor and cognitive processes through ample spinal and supratentorial projections. Despite emerging evidence of adaptive neuroplasticity, cerebellar reorganisation in response to severe spinal insult early in life is poorly characterised. The objective of this study is the systematic characterisation of cerebellar integrity metrics in a cohort of adult poliomyelitis survivors as a template condition for longstanding lower motor neuron injury. Methods: A total of 143 participants, comprising 43 adult poliomyelitis survivors and 100 age-and sex-matched healthy controls were recruited in a prospective, single-centre neuroimaging study with a uniform structural and diffusion imaging protocol. First, standard voxelwise grey and white matter analyses were performed. Then, the cerebellum was anatomically segmented into lobules, and cortical thickness and grey matter volumes were evaluated in each lobule. The integrity of cerebellar peduncles was also assessed based on their diffusivity profiles. Results: Compared to healthy controls, poliomyelitis survivors exhibited greater cortical thickness in lobules I, II, and III in the right hemisphere and in lobules VIIIA and VIIIB bilaterally. A trend of higher cortical thickness was also detected lobules I, II and III in the left hemisphere. Enhanced cerebellar peduncle organisation was detected, particularly within the middle cerebellar peduncles. Conclusions: Increased cerebellar integrity measures in poliomyelitis survivors are primarily identified in lobules associated with sensorimotor functions. The identified pattern of cerebellar reorganisation may represent compensatory changes in response to severe lower motor neuron injury in childhood and ensuing motor disability.

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Section: Discussioncontrasting

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Cerebellar remodelling decades after spinal cord insult: neuroplasticity in poliomyelitis survivors

Shing¹,

Murad²,

Lope³

et al. 2022

J. Integr. Neurosci.

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The Cerebellum and CNS Infection

Cohen¹,

Lipton²

1990

Infections of the Nervous System

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Enterovirus Infections

Jubelt¹

2012

Viral Infections of the Human Nervous System

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The human enteroviruses (EV) comprise one group of the picornavirus family. The best known members are the polioviruses (PV), coxsackieviruses, and echoviruses. They replicate in the oropharynx and gastrointestinal (GI) tract and are primarily spread by fecal-hand-oral contamination. With systemic invasion nonspecific febrile illness occurs as well as specific syndromes (rashes, hand-footand-mouth disease, herpangina, pleurodynia, myocarditis/pericarditis, and conjunctivitis). With systemic replication a high level viremia may result in central nervous system (CNS) invasion. EV activity can be endemic in warm climates or epidemic in temperate climates. In temperate climates, because of improved hygiene, newborns were not exposed to EV until they were older, resulting in large epidemics of poliomyelitis, which were finally curtailed with the killed PV vaccines in the 1950s and the live oral PV vaccines in the 1960s. Today, "aseptic" meningitis is the most common neurologic syndrome caused by EV. EV are also the most common cause of viral meningitis. Other EV neurologic syndromes include encephalitis, rhombencephalitis, paralytic disease, persistent infections, and the severe group B coxsackievirus fatal systemic infections of neonates. Diagnostic clues can come from epidemics, systemic manifestations, household infections, the cerebrospinal picture, and the neurologic syndrome. However, definite diagnosis depends on laboratory methods, primarily nucleic acid amplification. Treatment of acute infections is supportive. Preventative methods include good hygiene and aggressive polio vaccination programs.

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Acute Cerebellar Ataxia in Children Associated With Infection by Poliovirus I

Cited by 14 publications

References 0 publications

Cerebellar remodelling decades after spinal cord insult: neuroplasticity in poliomyelitis survivors

Cerebellar remodelling decades after spinal cord insult: neuroplasticity in poliomyelitis survivors

The Cerebellum and CNS Infection

Enterovirus Infections

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