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Acute flaccid myelitis outbreak through 2016-2018: A multicenter experience from Turkey
Olcay Ünver1, Dilşad Türkdoğan1, Serhat Güler2
1Division of Pediatric Neurology, Department of Pediatrics, Marmara University School of Medicine, İstanbul, Turkey.
Summary
Acute flaccid myelitis cases, primarily in children, have increased with outbreaks every two years. Persistent weakness is common, and early intervention is crucial for better outcomes in this rare condition.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Acute flaccid myelitis (AFM) is a rare but serious neurological condition affecting the spinal cord.
- Recent years have seen an increase in AFM cases, particularly among pediatric populations.
Purpose of the Study:
- To describe the demographic, etiologic, neurophysiologic, and imaging characteristics of AFM.
- To analyze treatment, prognosis, and prognostic factors in pediatric AFM patients.
Main Methods:
- Retrospective review of clinical data, laboratory tests, and MRI results for pediatric AFM patients (August 2016-December 2018).
- Data collected from 13 centers in Turkey, adhering to CDC diagnostic criteria.
Main Results:
- 31 confirmed AFM cases (91.2%) were identified, with a median age of 4 years.
- Entero/rhinoviruses were the most common infectious agents. 91.2% of patients received immunotherapy.
- Persistent weakness was observed in 88.9% of patients with follow-up data. Limb involvement and abnormal brain MRI predicted poor prognosis.
Conclusions:
- AFM incidence shows a bimodal pattern, increasing every two years, predominantly in children, with a decreasing median age during outbreaks.
- Early specimen collection and initiation of rehabilitation are vital for managing AFM.
- Further research is necessary to elucidate the etiology, pathogenesis, risk factors, and optimal treatments for AFM.
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