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[Acute Flaccid Myelitis].

Ryutaro Kira1

  • 1Department of Pediatric Neurology, Fukuoka Children's Hospital.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|February 13, 2018
PubMed
Summary
This summary is machine-generated.

Acute flaccid myelitis (AFM) is a rare neurological condition. While linked to enterovirus D68, its exact cause remains unknown, and current treatments show limited effectiveness.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Acute flaccid myelitis (AFM) is a distinct neurological syndrome characterized by acute flaccid paralysis.
  • AFM cases have temporally coincided with enterovirus D68 (EV-D68) outbreaks in the US and Japan.
  • The precise etiology of AFM remains largely unknown.

Purpose of the Study:

  • To summarize the clinical features, epidemiology, and outcomes of acute flaccid myelitis.
  • To explore the association between AFM and enterovirus D68.
  • To review current therapeutic approaches and identify needs for future research.

Main Methods:

  • Review of clinical data from AFM patients during outbreaks.
  • Analysis of viral detection in respiratory and cerebrospinal fluid samples.
  • Assessment of neuroimaging, cerebrospinal fluid analysis, and neurophysiological findings.
  • Evaluation of patient outcomes following immunomodulation therapy.

Main Results:

  • AFM presents with focal limb weakness and cranial nerve dysfunction, often with extensive spinal cord involvement on MRI.
  • EV-D68 was detected in a minority of AFM patients, primarily in respiratory samples.
  • Immunomodulatory therapies (IVIG, pulse methylprednisolone) did not significantly improve prognosis.
  • Complete recovery was rare, with most patients experiencing residual weakness.

Conclusions:

  • The link between EV-D68 and AFM is suggested by temporal associations but not definitively proven by viral detection in all cases.
  • Current treatments for AFM are largely ineffective in the acute stage.
  • Further research into AFM pathophysiology and novel therapeutic strategies is crucial.