Medicine:Hopkins syndrome
| Hopkins syndrome | |
|---|---|
| Specialty | Neurology |
Hopkins syndrome is a neurological disorder. Its cause has not been established, but its association with asthma exacerbations (usually with a respiratory infection as a trigger) has led to suspicion that the initial viral insult that causes the respiratory infection is also implicated in the subsequent paralysis. Herpes simplex virus type I DNA has been found in the cerebrospinal fluid of at least one patient diagnosed with Hopkins syndrome.[1] In several cases, anti-viral antibody titers for echovirus, enterovirus, coxsackievirus and poliovirus types 1, 2 and 3 were specifically sought; all were negative.[2],[3] There is one reported case in which Mycoplasma pneumoniae infection was found in the patient.[4]
The syndrome appears to involve the spinal cord: specifically, the anterior horn cells subserving the affected muscles are often damaged. The evidence for anterior horn cell involvement comes from radiological[3],[5],[6] and electromyographical studies.[4] In one case, a biopsy of an affected muscle "revealed scattered atrophic fibers, indicating lesions in the anterior horn cells of the spinal cord".[7]
As the illness is rare, no treatments have been subjected to a randomized controlled trial. Acyclovir,[1] steroids and therapeutic plasma exchange have been tried; one report suggests that the latter is more effective than steroidal therapy.[8] The prognosis for recovery of function of the affected limbs is generally considered to be poor.
References
- ↑ 1.0 1.1 Kyllerman, MG; Herner, S; Bergström, TB; Ekholm, SE (1993). "PCR diagnosis of primary herpesvirus type I in poliomyelitis-like paralysis and respiratory tract disease". Pediatric Neurology 9 (3): 227–9. doi:10.1016/0887-8994(93)90091-P. PMID 8394714.
- ↑ Okayama, A; Hara, H; Shigeto, H; Yamada, T; Kira, J (1999). "A case of Hopkins syndrome with onset at puberty". Rinsho Shinkeigaku 39 (4): 452–5. PMID 10391972.
- ↑ 3.0 3.1 Kurokawa, T; Taniwaki, T; Arakawa, K; Yamada, T; Kira, J (2000). "An adult case of recurrent myelopathy presenting with monoplegia following asthmatic attacks". Fukuoka Igaku Zasshi = Hukuoka Acta Medica 91 (3): 85–9. PMID 10826222.
- ↑ 4.0 4.1 Acharya, AB; Lakhani, PK (1997). "Hopkins syndrome associated with Mycoplasma infection". Pediatric Neurology 16 (1): 54–5. doi:10.1016/S0887-8994(96)00248-2. PMID 9044403.
- ↑ Nakano, Y; Kohira, R; Yamazaki, H; Fujita, N; Fuchigami, T; Okubo, O; Harada, K (2001). "Hopkins syndrome: oral prednisolone was effective for the paralysis". No to Hattatsu. Brain and Development 33 (1): 69–73. PMID 11197900.
- ↑ Arita, J; Nakae, Y; Matsushima, H; Maekawa, K (1995). "Hopkins syndrome: T2-weighted high intensity of anterior horn on spinal MR imaging". Pediatric Neurology 13 (3): 263–5. doi:10.1016/0887-8994(95)00181-E. PMID 8554668.
- ↑ Mizuno, Y; Komori, S; Shigetomo, R; Kurihara, E; Tamagawa, K; Komiya, K (1995). "Poliomyelitis-like illness after acute asthma (Hopkins syndrome): a histological study of biopsied muscle in a case". Brain & Development 17 (2): 126–9. doi:10.1016/0387-7604(94)00125-H. PMID 7625547.
- ↑ Kira, J (2003). "Neural damage associated with allergic diseases: pathomechanism and therapy". Rinsho Shinkeigaku 43 (11): 756–60. PMID 15152457.
 |  |
