Key result
A multifactorial setup of immune suppression, stress, and neurotoxic drugs during an acute asthma attack may render patients vulnerable to anterior horn cell invasion by non-polio enteroviruses.
Case Report (n=22)
Acute flaccid paralysis during recovery from asthma may be caused by enterovirus invasion of the anterior horn cells, facilitated by immune suppression, stress, and neurotoxic drugs.
May warrant enterovirus testing in post-asthma acute flaccid paralysis; case report leaves open multifactorial predisposition.
A poliomyelitis-like paralytic disease during recovery from an attack of bronchial asthma is described in two young children. They presented at the age of 13 and 22 months, respectively, with acute flaccid paralysis of one or both lower limbs and preserved sensation. Cerebrospinal fluid examinations revealed mild protein elevation in both and pleocytosis in the second infant. Enteroviruses were isolated in a nasal swab and stools of the second patient. Acute onset of flaccid paralysis with absent motor action potential and normal sensory responses, detected by electrophysiologic studies, are highly suggestive of motor anterior horn cell disease in these infants. A multifactorial setup of immune suppression, stress, and neurotoxic drugs during an acute bronchial asthma attack triggered by a viral disease may render the patient vulnerable to viral invasion of the anterior horn cell with enteroviruses other than poliovirus. The overall experience of 22 patients with this serious complication is reviewed.
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Shahar et al. (1991) conducted a case report in Poliomyelitis-like paralysis during recovery from acute bronchial asthma (n=22). Viral infection and acute bronchial asthma attack was evaluated on Acute flaccid paralysis. A multifactorial setup of immune suppression, stress, and neurotoxic drugs during an acute asthma attack may render patients vulnerable to anterior horn cell invasion by non-polio enteroviruses.
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