MRI findings in an infant with vaccine-associated paralytic poliomyelitis

Abstract

Although acute flaccid paralysis is a manifestation observed in several neurologic and muscular disorders, vaccine-associated paralytic poliomyelitis (VAPP) is an exceedingly rare etiology. In the clinical setting of acute flaccid paralysis, MRI is useful in differentiating between VAPP and other conditions. Additionally, MRI can assess the extent of lesions. However, reports on MRI findings in VAPP are scarce in the pediatric radiology literature. We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered.

The muscle findings in a pediatric patient with live attenuated oral polio vaccine-related flaccid monoplegia

“…The routine ATPase staining presented mild type 2 muscle atrophy. lesion after the recovery phase in this patient, later than 7 years and more, even with 3.0 Te MRI [1,2]. Because of the small and localized lesion, this patient could not detect a distinct MRI finding of the denervated lesion of spinal cord after the recovery phase.…”

Multidisciplinary Approach to Tropical and Subtropical Infectious Diseases: Imaging with Pathologic Correlation

“…CSF evaluation and isolation of the virus from stool culture is important because similar imaging findings can be seen in acute disseminated encephalomyelitis, several other viral encephalitides, and demyelinating illnesses. [18][19][20][21] …”

Revisiting the spectrum of lower motor neuron diseases with snake eyes appearance on magnetic resonance imaging

“…Traditionally, this clinico‐radiological entity has been most commonly associated with cervical spondylosis, spinal cord infarction and Hirayama disease. Anterior horn high signal has also been noted in post‐vaccination poliomyelitis , West Nile virus encephalitis , enterovirus , dengue myelitis , HIV myelitis , tick‐borne encephalomyelitis and varicella zoster virus . It has also been reported in neuromyelitis optica (Devic's disease) , paraneoplastic myelopathies and Hopkins syndrome .…”