Lumbosacral radiculomyelitis associated with pandemic acute hæmorrhagic conjunctivitis

Abstract

In 1971 Bombay city and other parts of India were gripped by an epidemic of acute hæmorrhagic conjunctivitis (A.H.C.), approximately 500,000 patients being seen in Bombay between March and September. During this period, cases of an acute neurological syndrome were seen in patients who had had or had been in contact with A.H.C. This syndrome was characterised by lancinating root pains occasionally preceded by fever and malaise and quickly followed by proximal flaccid weakness of the lower limbs (especially in the quadriceps), areflexia, and occasional plantar extensor response. In some, the cerebrospinal fluid showed an increase in the protein content and mild pleocytosis, and electromyographic findings revealed a partial denervation in the affected muscles with normal nerve-conduction velocities. Both A.H.C. and the neurological disorder were believed to be due to the same virus, although no virus was isolated in Bombay. In Japan, no neurological cases have been reported in association with A.H.C., but a polio-like enterovirus has been cultured from the conjunctiva of Japanese patients.