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Acute Flaccid Myelitis: A Clinical Review
Olwen C Murphy1, Carlos A Pardo1
1Johns Hopkins Myelitis and Myelopathy Center, Division of Neuroimmunology and Neurological Infections, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Seminars in Neurology
|March 7, 2020
Summary
Acute flaccid myelitis (AFM) is a rare, polio-like illness causing sudden weakness in children. Enterovirus D68 is a suspected cause, presenting diagnostic challenges for physicians.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Acute flaccid myelitis (AFM) is an emerging neurological disorder affecting children.
- Characterized by acute flaccid paralysis and spinal cord gray matter abnormalities.
- Presents with polio-like symptoms, including limb weakness and potential respiratory compromise.
Purpose of the Study:
- To review the epidemiology, clinical features, and diagnosis of AFM.
- To discuss potential etiological factors, particularly viral links.
- To provide insights into differential diagnosis, treatment, and outcomes.
Main Methods:
- Review of epidemiological data and clinical case characteristics.
- Analysis of proposed viral associations, including enterovirus D68.
- Comparison with other causes of acute flaccid paralysis.
Main Results:
- AFM exhibits seasonal peaks in the US, occurring biennially since 2012.
- Nonpolio enteroviruses, especially enterovirus D68, are strongly associated.
- Differentiating AFM from conditions like Guillain-Barre syndrome is challenging.
Conclusions:
- AFM is a rare but significant condition requiring prompt recognition.
- Understanding its viral etiology is crucial for diagnosis and management.
- Further research is needed to elucidate AFM's pathogenesis and improve patient outcomes.
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