Overcoming Hand Paralysis from Enterovirus: Treatment Options for Children

Hand paralysis caused by enterovirus?

Hello, Doctor.
My son is currently 4 years old.
When he was 9 months old, he contracted Enterovirus 71, which caused him to be unconscious for two to three days and led to spinal meningitis.
He experienced paralysis in his left hand and left leg.
After rehabilitation, his left leg has returned to normal, but there has been no improvement in his left hand.
When he was about 2 years old, he underwent neurosurgery.
The function below his left wrist is still normal, but his shoulder is dislocated, and his upper limb has atrophied and is shorter in length.
The doctor has suggested another surgery to connect the hand nerves using intercostal nerves and to use thigh muscle to replace the muscle in his hand.
However, this surgery is quite extensive and has uncertain outcomes, so I am hesitant to proceed.
I would like to ask if there are better methods or resources available that could help improve my child's hand function.
Thank you.

Danxin de mama, 30~39 year old female. Ask Date: 2004/10/11

Dr. Xiao Furen reply Neurosurgery

It is unfortunate to see another victim of enterovirus.
However, given the current situation, there are likely very few who can confidently say they can cure it.
If there are indeed issues with the cervical spinal cord, the only option may be to attempt using intercostal nerves.
I think you should ask the original treating physician; he should be willing to provide you with more information.

Reply Date: 2004/10/11

More Info

Dear Parent,
Thank you for sharing your concerns regarding your son's condition following his battle with enterovirus type 71, which has led to significant challenges, particularly with his left hand. It is understandable to feel apprehensive about further surgical interventions, especially given the complexities of his situation.
Firstly, it is important to acknowledge that enterovirus infections, particularly those that lead to neurological complications like meningitis, can result in varying degrees of motor impairment. The paralysis your son is experiencing is a known consequence of such infections, and recovery can be a lengthy and uncertain process.
In terms of treatment options, there are several avenues you might consider:
1. Physical and Occupational Therapy: Engaging in a structured rehabilitation program can be immensely beneficial. Physical therapy focuses on improving mobility and strength, while occupational therapy can help your son develop fine motor skills and adapt to daily activities. Therapists can tailor exercises to his specific needs, which may help improve function in his hand over time.

2. Neurorehabilitation Techniques: Advanced rehabilitation techniques, such as constraint-induced movement therapy (CIMT), can encourage the use of the affected hand by restricting the use of the unaffected hand. This method has shown promising results in children with hemiparesis.

3. Assistive Devices: Depending on the extent of his hand function, various assistive devices can be utilized to aid in daily activities. These can range from simple tools that help with gripping to more complex adaptive devices that facilitate independence.

4. Surgical Options: While you mentioned hesitance regarding further surgery, it is worth discussing all potential surgical options with a pediatric orthopedic surgeon or a specialist in pediatric neurology. They can provide insights into the risks and benefits of procedures like nerve grafting or muscle transfers, which may improve function in the hand. It’s essential to weigh these options carefully, considering both the potential for improvement and the associated risks.

5. Alternative Therapies: Some parents explore complementary therapies such as acupuncture, massage, or even music therapy, which can sometimes help with pain management and improve overall well-being. However, these should be approached with caution and ideally discussed with your healthcare provider.

6. Support Groups and Resources: Connecting with support groups for families dealing with similar challenges can provide emotional support and practical advice. Organizations focused on childhood neurological disorders may also offer resources, including information on the latest research and treatment options.

7. Regular Follow-ups: Continuous monitoring by a pediatric neurologist or rehabilitation specialist is crucial. They can assess your son’s progress and adjust treatment plans as necessary.

In conclusion, while the journey to recovery may be challenging, there are various strategies and resources available that can help improve your son's hand function and overall quality of life. It is essential to maintain open communication with your healthcare team, ensuring that all options are explored and that your son receives the best possible care tailored to his unique needs.

Wishing you and your son all the best on this journey toward recovery.

Sincerely,
Doctor Q&A Teams

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