MRI findings of enteroviral encephalomyelitis

IntroductionThe majority of enterovirus infection in pediatrics presented with hand–foot–mouth disease and oral ulcers. A few of these patients had manifestations of polio like encephalitis and acute flaccid paralysis.Aim of the workThe aim of our study was to highlight the MR imaging features of enterovirus infection of the brain and spinal cord.Patients25 patients with hand–foot–mouth disease and clinical diagnosis of encephalitis were included in this study.MethodsIt is a retrospective study with respect to the confidentiality of the medical record. The patients were exposed to MR imaging with T1WI images pre and post contrast, and T2WI MR images, FLAIR, susceptibility weighted imaging (SWI), and diffusion weighted imaging (DWI) were obtained in all patients. Enterovirus culture confirmation was available in some cases.ResultsMR imaging of the 25 patients revealed 5 patients with normal MRI brain examination. T2 hyperintensity within the brain stem was seen in 16 patients, while 2 patients showed cervical cord lesions and two patients with dentate nuclei lesions.ConclusionEnterovirus encephalomyelitis has characteristic lesion locations in the posterior portions of the brain stem, substantia nigra, dentate nucleus and within the anterior horns of spinal cord. Recognition of these findings in the presence of suggestive clinical presentation can help to establish the diagnosis of enterovirus encephalomyelitis.