Acute myelitis after asthma attacks with onset after puberty

A poliomyelitis-like illness after asthma attacks has been found and is cal led asthmatic amyotrophy (Hopkins' syndrome). All of the previously reporte d cases were under 13 years of age. Three patients are described who develo ped acute myelitis after asthma attacks at 15, 22, and 73 years of age. All of them showed acute flaccid monoparesis, and needle EMG disclosed denerva tion potentials in the relevant muscles. In addition, in the two adult pati ents the sensory or pyramidal tracts were involved, and evoked potential st udies confirmed an involvement of the pyramidal tracts in one of them. This 22 year old patient showed a second episode of monoparesis in the other li mb after another asthma attack. All three patients had no significant chang es in their antiviral antibody titres, whereas every patient had hyperIgEae mia and allergen specific IgE. These findings suggest that asthmatic amyotr ophy can develop after puberty and that patients who develop this disease i n adulthood seem to show both a widespread involvement of the spinal cord a nd a more varied course.