Table 1.
Summary of cohorts of children of AFM described after 2012, showing patient characteristics, clinical findings, and findings on further investigations
| Author | Inclusion period | Country/region | No pts | EV-D68 pos | Gender (% male) | Age (mean or median with range) | Prodrome (%) | Limb weakness (%) | Asymmetry (%) | Sensory involvement (%) | Hyporeflexia (%) | Cranial nerve dysfunction (%) | Ventilatory support (%) | Bowel/bladder dysfunction (%) | CSF pleocytosis (%) | Protein raised in CSF (%) | MRI spine: T2 hyperintensity (%) | Nerve root enhancement (%) | Brainstem lesions | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Andersen | 2001–2014 | Australia | 8 | 0% (13% EV-A71) | 25 | Med 5 | 100 | 100 | 100 | 0 | NS | 25 | NS | 0 | 85 | 71 | 100 | 38 | 25 |
| 2 | Messacar | 2012–2015 | USA | 159a | 20–45% | 56–91 | Med 7.1 (0.4–73) | 64–100 | 83–100 | 47–70 | 21–44 | 80–81 | 18–83 | 9–34 | 18–51 | 64–91 | 45–58 | 90–100 | 20–40 | 35–75 |
| 3 | Elrick | 2012–2016 | USA | 34 | 13% | 65 | Med 5 (< 1–15) | 100 | 100 | 97 | 0 | 67 | > 24 | 24 | 6 | 97 | 45 | 100 | 38 | 62 |
| 4 | Yea | 2014 | Canada | 25 | 28% | 64 | Med 7.8 (0.8-15.0) | 88 | 100 | NS | 12 | 88 | > 20 | 28 | 36 | 72 | 28 | 100 | 72 | 32 |
| 5 | Gordon-Lipkin | 2014–2017 | USA | 16 | 23% | 69 | Med 4 (3–6) | 100 | 100 | NS | 6 | 63 | 50 | 31 | NS | 100 | NS (Med 6.3 g/L) | 100 | 13 | 42 |
| 6 | Chong | 2015 | Japan | 59 | 15% | 59 | Med 4.4 (2.6–77) | 97 | 100 | 68 | 20 | 90 | 17 | 8 | 27 | 85 | 46 | 100 | 51 | 42 |
| 7 | Knoester | 2015–2016 | Europe | 29 | 100%b | 52 | Med 4 (1.6–55) | 92 | 100 | NS (usual) | 7 | 87 | 60 | 66 | 7 | 91 | NS (Med 3.8 g/L) | 92 | 16 | 68 |
| 8 | Bonwitt | 2016 | USA | 10 | 20% (10% EV-A71) | 70 | Med 6 (3–14) | 80 | 100 | NS | NS | NS | 30 | 10 | 50 | 78 | NS (Med 5.8 g/L) | 100 | 0 | 30 |
| 9 | Iverson | 2016 | USA | 5 | 60% | 20 | Mean 7.7 (3.5–12) | 100 | 100 | NS | NS | NS | 80 | NS | NS | 100 | NS | 80 | NS | NS |
| 10 | Hübner | 2016 | Germany | 16 (7)c | 6% | 50 | Mean 4.6 (1.7-14.3) | 100 | 100 | 86 | NS | NS | NS | 14 | NS | 43 | NS | 86 | NS | NS |
| 11 | Ruggieri | 2016 | Argentina | 11 | 36% | 54 | Mean 3.2 (0.3–6) | 100 | 100 | 81 | 0 | 100 | 45 | 36 | 0 | 63 | 18 | 100 | NS | 45 |
| 12 | Sarmast | 2017 | India | 9 | 0% | 56 | Med 5.5 (2–7) | 100 | 100 | 100 | 0 | 100 | 11 | NS | 0 | 89 | 22 | 100 | NS | 11 |
| 13 | McKay | 2018 | USA | 80 | 37% (29% EV-A71) | 59 | Med 4 (0.7–32) | 99 | 100 | NS | NS | NS | NS | NS | NS | 83 | NS (Med 4.7 g/L) | 100 | NS | NS |
| 14 | Ramsay | 2018 | UK | 40 (16)d | 36% | 53 | 55% under 5 yo | 55 | 98 | NS | NS | NS | NS | 55 | NS | 18 | NS | 43 | NS | NS |
No pts, number of patients; EV-D88, enterovirus D68; EV-A71, enterovirus A71; med, median; CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; USA, United States of America; UK, United Kingdom; NS, not specified; yo, year old
aCombination of four US cohorts with a partial overlap in these cohorts
bEV-D68 had to be identified for inclusion
c16 registered cases, 7 of which were further described
d40 cases of Acute Flaccid Paralysis, of which 16 fulfilled the criteria for probable or definite AFM