Acute Flaccid Myelitis: A Multidisciplinary Protocol to Optimize Diagnosis and Evaluation

Area of Science:

• Neurology
• Pediatrics
• Infectious Disease Epidemiology

Background:

• Acute flaccid myelitis (AFM) is an emerging neurologic illness first identified in 2014, primarily impacting young children.
• AFM cases exhibit a biennial peak, typically occurring in late summer to fall, with a predicted increase in 2020.
• Delayed diagnosis and variable evaluation contribute to suboptimal care and high morbidity in AFM patients.

Purpose of the Study:

• To share findings from a 2018 case review of AFM patients.
• To disseminate a newly developed protocol for the evaluation and management of pediatric AFM.
• To promote a standardized, multidisciplinary approach to AFM care.

Main Methods:

• Review of acute flaccid myelitis patients treated in 2018.
• Development of a comprehensive protocol based on local experience, expert consensus, and literature review.
• The protocol addresses the full spectrum of care, from initial presentation to long-term rehabilitation.

Main Results:

• A 2018 case review revealed significant variability in presentation, evaluation, and treatment timelines for AFM.
• A standardized protocol was developed to address these inconsistencies.
• The protocol provides a structured approach for managing pediatric AFM.

Conclusions:

• Standardized, multidisciplinary care is essential for optimizing outcomes in acute flaccid myelitis.
• Dissemination of the developed protocol aims to inform a standardized approach to AFM.
• Encouraging the formation of multidisciplinary AFM teams can enhance expert care throughout the disease trajectory.