Mumps Associated Acute Motor Axonal Polyneuropathy

Viral Infections of the Central Nervous System in Children: A Systematic Review

Viral infections of the central nervous system such as meningitis, encephalitis or meningoencephalitis, are important causes of significant morbidities and mortality worldwide. Early diagnosis and prompt treatment will lead to better outcomes, but any delay may results in high fatality with serious neurologic sequelae among survivors. We conducted a systematic review of published literature on the clinical presentation, diagnosis, treatment and complications of viral infections of the central nervous system from 1980 to 2019 on four databases comprising of PubMed, PubMed Central, Google Scholar and Medline to give the current understanding for better patient management. This systematic review demonstrates the management approach of viral infections of the central nervous system in children from the point of clinical presentation, diagnosis, treatment and complications. Definitive treatment remained unknown; however, certain antiviral drugs were proved to be effective. Therefore, prevention through childhood vaccination is the best management option.

Post-mumps acute disseminated encephalomyelitis in an adolescent

Mumps is an acute communicable self-limiting swelling of the parotid or other salivary glands. Various organs can be involved including the testes, central nervous system, mammary glands, ovary, pancreas, kidneys, and heart. We hereby present a rare case of an 18-year-old unvaccinated male with acute disseminated encephalomyelitis following mumps without parotitis.

Acute Motor Axonal Polyneuropathy Following Mumps Infection in a 9-Year-Old Girl

A 9-year-old girl presented with lower motor neuron type of paralysis involving limbs, trunk and multiple cranial nerves (7, 9 and 10) with preceding history of mumps 1 week before the onset of weakness. There were no features to suggest either a meningitis or encephalitis in the child. Cerebrospinal fluid showed hypoglycorrhachia and mild protein elevation; magnetic resonance imaging of the brain was normal. Nerve conduction study showed motor axonal neuropathy. Serology for mumps IgM was positive, consistent with a diagnosis of post-mumps acute motor axonal polyneuropathy. The girl made a complete recovery within 3 weeks.

Acute disseminated encephalomyelitis: complication of a vaccine preventable disease

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory-demyelinating disease of central nervous system. Several viral infections and vaccines act as precipitating factor for ADEM. We report an 8-year-old girl presenting with acute-onset flaccid paraparesis and bilateral painless vision loss. MRI brain showed extensive multifocal patchy demyelination and she made good clinical recovery with steroids and intravenous immunoglobulin therapy. She had history of bilateral parotid swelling before the onset of neurological symptoms and diagnosis of mumps was confirmed by positive ELISA in serum. Mumps, usually a benign and self-limited viral infection, rarely can cause severe neurological complications. Hence, we report this case to emphasise the importance of mumps vaccination and the need to strengthen the health policy system for the prevention of disease.