In rare cases, a child with asthma can develop symptoms of a syndrome known as Hopkins disease. What is Hopkins disease and what causes it?
Asthma can be a challenging disease – particularly for children who participate in sports or have frequent, difficult-to-control asthma attacks. Fortunately, there are treatments available to help kids who have to deal with this common lung condition. Tragically, a child with asthma can rarely develop an uncommon complication known as Hopkins syndrome. What is Hopkins disease?
What is Hopkins Disease?
Hopkins disease is a rare condition that affects asthmatic children known as acute post-asthmatic amyotrophy. This condition is seen only rarely, but when it is, the results can be devastating. It’s most common in children under the age of thirteen who have a history of asthma. Because the condition is so rare, it’s still perplexing to both doctors and researchers.
What are the Symptoms of Hopkins Disease?
Children with Hopkins disease develop symptoms within one to three weeks after an asthmatic attack. A child with this syndrome usually feels normal after the asthma attack, but then “out of the blue” develops paralysis in an arm or leg with complete loss of muscle tone. The arm or leg essentially goes limp and the child is unable to use it.
Despite the paralysis, the child has complete sensation – but an inability to move the affected limb. Hopkins disease sufferers may also have neck pain and stiffness – and the onset of symptoms is quite rapid and dramatic.
What Causes Hopkins Disease?
The disease appears to involve the anterior horn – the portion of the spinal cord that carries motor fibers responsible for movement – the same fibers that are damaged by polio and ALS. Another portion called the posterior horn that carries sensory fibers isn’t affected by this disease since children with Hopkins syndrome experience no loss of sensation – despite the leg or arm being paralyzed.
No one knows exactly what causes the damage to the anterior horn which leads to such devastating symptoms. It seems to strike more commonly after an asthmatic child suffers from a cold or other respiratory infection. Scientists believe that a virus may trigger the damage to the anterior horn of the spinal cord.
The Prognosis of Hopkins Disease?
Unfortunately, the long term outlook for Hopkins disease sufferers is poor. Most children don’t recover function of the affected arm or leg. Most treatments that have been attempted have failed – although one case resolved using gamma globulin therapy. Plasma exchange, steroids, and acyclovir have all been tried with only modest degrees of success.
The Bottom Line?
Fortunately, Hopkins disease is rare because it usually leads to permanent paralysis of the affected arm or leg. There aren’t any good treatments for this condition and research is limited because the disease is so uncommon. It’s a syndrome that still remains a mystery to most doctors.
Infection. Volume 26, Number 4 / July, 1998.
Am J Phys Med Rehabil. 1991 Dec;70(6):332-4.