Acute Neurologic Illness of Unknown Etiology in Children — Colorado, August–September 2014

• Published in: MMWR. Morbidity and mortality weekly report Vol. 63; no. 40; pp. 901 - 902
• Main Authors: Pastula, Daniel M., Aliabadi, Negar, Haynes, Amber K., Messacar, Kevin, Schreiner, Teri, Maloney, John, Dominguez, Samuel R., Davizon, Emily Spence, Leshem, Eyal, Fischer, Marc, Nix, W. Allan, Oberste, M. Steven, Seward, Jane, Feikin, Daniel, Miller, Lisa
• Format: Journal Article Newsletter
• Language: English
• Published: United States Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services 10-10-2014; U.S. Government Printing Office; U.S. Center for Disease Control; U.S. Centers for Disease Control
• Subjects: Acute Disease; Adolescent; Child; Child, Preschool; Children; Children & youth; Cluster Analysis; Colorado; Diseases; Enterovirus; Humans; Infant; Lesions; Magnetic resonance imaging; Nervous System Diseases - diagnosis; Nervous System Diseases - etiology; Neurological disorders; Public health; Respiratory diseases; Reverse transcriptase polymerase chain reaction; Colorado; United States > US
• ISSN: 0149-2195; 1545-861X

On September 12, 2014, CDC was notified by the Colorado Department of Public Health and Environment of a cluster of nine children evaluated at Children's Hospital Colorado with acute neurologic illness characterized by extremity weakness, cranial nerve dysfunction (e.g., diplopia, facial droop, dysphagia, or dysarthria), or both. Neurologic illness onsets occurred during August 8-September 15, 2014. The median age of the children was 8 years (range = 1-18 years). Other than neck, back, or extremity pain in some patients, all had normal sensation. All had a preceding febrile illness, most with upper respiratory symptoms, occurring 3-16 days (median = 7 days) before onset of neurologic illness. Seven of eight patients with magnetic resonance imaging of the spinal cord had nonenhancing lesions of the gray matter of the spinal cord spanning multiple levels, and seven of nine with magnetic resonance imaging of the brain had nonenhancing brainstem lesions (most commonly the dorsal pons). Two of five with magnetic resonance imaging of the lumbosacral region had gadolinium enhancement of the ventral nerve roots of the cauda equina. Eight children were up to date on polio vaccination. Eight have not yet fully recovered neurologically.