Acute Flaccid Myelitis With Neuroradiological Finding of Brachial Plexus Swelling

Area of Science:

• Neurology
• Radiology
• Infectious Diseases

Background:

• Acute flaccid myelitis (AFM) is a distinct neurological syndrome causing polio-like paralysis.
• AFM presents with spinal cord lesions, primarily affecting gray matter and anterior horn neurons.
• The exact mechanisms and full extent of AFM pathology remain under investigation.

Observation:

• This study details three AFM cases presenting with acute flaccid upper limb weakness following fever.
• Both spinal MRI and brachial plexus MRI were utilized to assess the extent of neurological involvement.
• Imaging was performed during the acute phase of the illness to capture early pathological changes.

Findings:

• Spinal MRI revealed extensive longitudinal lesions within the spinal cord, predominantly in the gray matter.
• Crucially, concurrent swelling and hyperintensity were observed in the brachial plexus of all three patients.
• These findings indicate significant pathology extending beyond the central nervous system.

Implications:

• The observed brachial plexus abnormalities suggest peripheral nerve involvement in AFM.
• This expands the understanding of AFM's pathological scope, potentially impacting diagnostic and therapeutic strategies.
• Further research is warranted to elucidate the precise mechanisms of peripheral nerve damage in AFM.