급성출혈성 결막염의 신경학적 합병증

Abstract

In 1969, Chatterjee et al reported new type of epidemic conjunctivitis called acute hemorrhagic conjunctivitis (AHC) or Apollo 11 disease. During 1970 and 1971 there were great outbreaks of AHC in the area of North Africa, Europe, middle east, and south east Asia and far East. In 1972 Kono et al isolated etiological agent from conjunctival swab named enterovirus 70. Wadia et al and Bharucha were reported clinical studies on neurological complications of AHC in 1972,

We were presented clinical studies on 8 cases of neurological complications of acute hemorrhagic conjunctivitis, these were seen at Keimyung University hospital after prevalence of AHC during summer time in 1981 in the area of Taegu, Korea. Clinical features of these neurological complications of AHC are summarized in table 1. Prodromal symptoms consisted of fever, headache, nausea, vomiting, general malaise, myalgia, backache, pain on extremities and urinary incontinence. Duration between the onset of AHC and the onset of prodromal symptoms were 12 to 40 days (mean 20 days). During or after the prodromal symptoms patients presented severe root pain involving part of the bodies, most involved lower extremities, followed by motor weakness, which are asymmetric, more often and severe on lower extremities than upper, more prominent on proximal, than distal, muscle atrophy and decreased or absent deep tendon relfexes and flexor plantar reflex (rarely extensor plantar reflex).

Duration between the onset of prodromal symptoms and the onset of motor weakness were 0—7 days (mean 3.4 days). Cerebrospinal fluid examination showed marked elevated protein and slight pleocytosis. Motor nerve conduction velocity showed normal except one who had delayed motor nerve conduction velocity of bilateral posterior tibial nerve. Titers of neutralizing antibody test revealed one patient had 1 ： 32 which was confirmative, three had 1 ： 8 which were doubtful and two had 1 ： 4 which were not significant.