MENINGO-ENCEPHALO-MYELO-RADICULITE A FLAVIVIRUS : PARESIE BI-BRACHIALE ET INSUFFISANCE RESPIRATOIRE

摘要: 3 patients developed rapid onset of fever and nuchal stiffness. Paresis brachial muscles occurred within 4 days all had respiratory failure that needed mechanical ventilation. At the peak disease there were bilateral asymmetrical severe atrophy brachial, shoulder neck muscles, cranial nerve pareses absent or weak deep reflexes in upper extremities. CSF analyses showed sterile lymphocytic pleocytosis. In 2 cases suffered a tick bite Switzerland third was probably bitten by an insect while opening package received from Indonesia. Patients defervescence serological tests found to be highly positive for IgM then IgG ELISA FSME (Fruhsommer-Meningoenzephalitis). The ventilated 5 weeks before progressive improvement seen. However, on follow-up at 12, 18 30 months respectively, proximal still atrophied quite weak. Our underline that: (1) FSME-ELISA results may cross-react with Japanese Central European encephalitis virus species; (2) Flaviviruses do induce unusual preferential long-term paralysis extremities simulating poliomyelitis; (3) studied electrophysiologically, signs axonal reinnervation not seen lower motor neuron syndrome which important permit progressive, but late, improvement; (4) is no evidence extension endemic foci tick-borne Switzerland.