Table 2.

Clinical and MRI follow-up findings of 12 patients with neurological complications of EV71-associated HFMD

Case no.	Follow-up after 4 months			Follow-up after 2 years
	Clinical findings	Brain MRI	Spinal cord MRI	Clinical findings	Brain MRI	Spinal cord MRI
Brainstem encephalitis
1	N/A (dead)	N/A	N/A	N/A	N/A	N/A
2	Mild bulbar palsy, grade 3 muscle strength in both upper limbs, grade 4 muscle strength in both lower limbs, tendon hyperreflexia, hypertonia	Mildly abnormal signal in the medulla oblongata and posterior pons	Mildly abnormal signal in the whole length of the spinal cord	Mild right-sided facial weakness, slightly high-arched feet	Remaining medullary abnormalities	Mild abnormalities in the thoracolumbar cord
3	Grade 3 muscle strength in both upper limbs, tendon hyperreflexia in both lower limbs	The abnormal signals in the medulla oblongata and posterior pons had almost disappeared	Bilateral hypointense signal at C1-C4	Mild limb weakness	Normal	Normal
4	Mild facial paralysis	The patchy mildly hyperintense signals on T2-weighted images in the posterior pons had almost disappeared	N/A	Normal	Normal	N/A
5	Mild bulbar palsy	The abnormal signals in the medulla oblongata and posterior pons had decreased	N/A	Normal	Normal	N/A
6	Mild oculomotor dysfunction, normal muscle strength in all limbs, hypertonia in all limbs, tendon hyperreflexia	The patchy signal in the posterior brainstem had almost disappeared	N/A	Normal	Normal	N/A
Aseptic meningitis
7	Normal	Normal	N/A	N/A	N/A	N/A
8	Normal	Normal	N/A	N/A	N/A	N/A
Acute flaccid paralysis
9	Grade 4 muscle strength in both lower limbs, normal tendon reflexes, hypertonia	N/A	Bilateral hypointense signal at T10-L1	Normal	N/A	Normal
10	Grade 4 muscle strength in both lower limbs, tendon hyporeflexia in both lower limbs, hypertonia	N/A	Bilateral hypointense signal at T9-L1, the bilateral enhancement of the anterior roots had disappeared	Normal	N/A	Normal
11	Grade 2 muscle strength in the right upper limb, tendon hyporeflexia in the right upper limb, hypertonia	N/A	Bilateral mildly abnormal signal at C4-C7	Mild upper limb weakness	N/A	Mild abnormalities in the cervical cord
12	Grade 4 muscle strength in the left lower limb	N/A	Left-sided mildly abnormal signal at T9-L1	Normal	N/A	Normal