Long-term neurodevelopment outcomes of hand, foot and mouth disease inpatients infected with EV-A71 or CV-A16, a retrospective cohort study

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  Figure 1.. Flow chart for the enrolment and the assessments performed at follow-up of 176 patients. a: 38 patients with underlying conditions: 16 with prior learning disability or neurological regression, 6 with prior chronic respiratory or cardiac illness, 13 with previous pediatric intensive care unit admission and 3 with prior delayed development. b: MRI results included available reexamination results after the acute episode to follow-up (8 brain MRI and 2 spine MRI) by reviewing picture archiving and communication system. Numbers of patients applied in the neurodevelopment assessments may differ due to different age covered by the different assessments. ABAS-II Adaptive Behavior Assessment System, second Edition. WPPSI-IV Wechsler preschool and primary scale of intelligence, Fourth edition. WISC-IV Wechsler intelligence scale for children, fourth edition. MABC-II Movement Assessment Battery, second edition. MRI Magnetic Resonance Imaging. EMG Electromyography.

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  Figure 2.. Detailed neurologic examination outcome at discharge and at follow-up by complications of 171 patients. Five cases refused neurological examination at follow-up. Each panel represents a neurologic finding except panel A is overall. The panel ranks neurologic examination outcome in decreasing order of overall percentage of outcome at follow-up. CNS central nervous system. ANS autonomic nervous system dysregulation. CRF cardiorespiratory failure.

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  Figure 3.. Lesion location identified by MRI for individual case with or without motor dysfunction. Cases were both brain MRI performed at acute episode and motor assessment at follow-up. MRI results included available reexamination results after the acute episode to follow-up (5 brain MRI and 2 spine MRI) by reviewing picture archiving and communication system. Motor dysfunction is defined total motor scaled score ≤7 of MABC-2 evaluation. The number is case ID. Thalamus and cortex has significant difference between motor dysfunction and no motor dysfunction at follow-up (p = 0.011, p = 0.019).