Enterovirus rhomboencephalitis is the most common neurological complication of enterovirus infection 1.
Enterovirus rhomboencephalitis causes acute and severe neurologic disorders such as ataxia, nystagmus, oculomotor palsies, or bulbar palsy. In some cases, neurologic affection can extend to the spinal cord 1.
Diagnosis usually made by neuroimaging findings in conjunction with virus isolation from at least one site (throat swab, stool, CSF)
EV71 brainstem encephalitis occasionally induces autonomic dysfunction, such as fluctuating blood pressure and pulmonary hemorrhage/edema leading to death.
Brainstem is the most common site of involvement. High signal intensities on T2-weighted and fluid-attenuated inversion recovery images in the dorsal aspect of the pons, medulla, midbrain and dentate nuclei, the dorsal aspect of the pons (pontine tegmentum) is the most common site of brainstem involvement 1.
Ventral pontine lesions, substantia nigra and dentate nuclei affection can be found.
Usually no supratentorial involvement.
Spinal cord can be identified. Cervical cord is most commonly to be involved. It shows increased signal throughout the entire spinal cord grey matter.
Possible differential considerations include
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