Abstract:

Objective: To summarize the early clinical characteristics, medical experience and prognosis of severe hand-foot-mouth
disease （HFMD）merger with brainstem encephalitis. Methods: Clinical data from 52 cases of severe HFMD merger with brainstem
encephalitis children were retrospectively analyzed. Results: There were 38 cases of fever （73.08 %）, 40 cases of sluggishness
（76.76 %）, 46 cases of bockigkeit（88.46 %）, 36 cases of body shaking（69.23 %）, 21 cases of instability gait（40.38 %）, 31 cases
of sleepiness （59.61 %）, and knee hyper-reflexia or disappear in 25 patients （48.07 %）. With early and active use of mannitol,
methylprednisolone and intravenous immunoglobulin （IVIG）, and early mechanical ventilation when found the pulmonary edema, all
52 cases of patients were clinically cured with no legacy of neurological sequelae. Conclusion: Severe HFMD caused by EV71 are
more likely complicated with brainstem encephalitis. High fever, sluggishness, bockigkeit, body shaking, sleepiness, cool extremities
are the major indicaters of the early damaged nerve system of severe HFMD merger with brainstem encephalitis. Early detection and
intervention can reduce disease mortality and occurrence of sequelae.

Key words: hand-foot-mouth disease, brainstem encephalitis, early clinical performance