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Acute Flaccid Myelitis: A Single Pediatric Center Experience From 2014 to 2019

Rifali Patel1, Grace Y Gombolay2, Allan E Peljovich3

  • 1Pediatric Neurology, MercyOne, Des Moines, IA, USA.

Journal of Child Neurology
|July 18, 2020
PubMed

Insights

Acute flaccid myelitis (AFM) causes significant paralysis in children. Rehabilitation and nerve transfer surgery showed improvement in motor function, offering hope for affected children.

Area of Science:

  • Pediatric Neurology
  • Pediatric Physical Medicine and Rehabilitation
  • Pediatric Neurosurgery

Background:

  • Acute flaccid myelitis (AFM) is a leading cause of acute flaccid paralysis in children, resulting in significant physical disability.
  • Objective outcome measures are crucial for assessing AFM severity and progression.
  • Further research into nerve transfer techniques for improving motor function in affected children is needed.

Purpose of the Study:

  • To evaluate the clinical characteristics and outcomes of pediatric patients with acute flaccid myelitis.
  • To assess the effectiveness of comprehensive rehabilitation and nerve transfer surgery in improving motor function.

Main Methods:

  • Retrospective study of 15 pediatric patients with AFM managed between August 2014 and December 2019.
  • Review of clinical data, electrodiagnostic studies (electromyography and nerve conduction studies), and functional independence measures (WeeFIM).
  • Analysis of outcomes following nerve transfer surgery and comprehensive inpatient rehabilitation.

Main Results:

  • All 15 patients presented with severe asymmetric motor weakness and absent reflexes; 93% had reduced motor amplitudes on nerve conduction studies.
  • WeeFIM scores indicated deficits primarily in self-care and mobility domains.
  • Following nerve transfer surgery in 6 children (13 limbs), 4 subjects showed improved active movement scale scores at a mean follow-up of 10.4 months.

Conclusions:

  • Acute flaccid myelitis in children is characterized by asymmetric motor weakness and electrophysiological abnormalities.
  • Comprehensive rehabilitation and nerve transfer interventions demonstrated potential for improving motor function in pediatric AFM patients.
  • Objective measures like WeeFIM and AMS are valuable for tracking recovery and treatment efficacy in AFM.
Abstract

Keywords:
Acute flaccid paralysisEMG/NCSWeeFIMactive movement scaleacute flaccid myelitisnerve transfer

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