Does acute flaccid myelitis cause respiratory failure in children?

Area of Science:

• Neurology
• Pediatrics
• Pulmonology

Background:

• Acute flaccid myelitis (AFM) is a rare neurological condition affecting spinal cord gray matter, leading to limb weakness and potential respiratory compromise.
• Cervical spinal cord involvement in AFM increases the risk of respiratory failure, necessitating a thorough understanding of its impact.

Purpose of the Study:

• To describe respiratory failure in pediatric patients with acute flaccid myelitis.
• To emphasize the need for assisted ventilation and respiratory nerve involvement in AFM from acute and long-term perspectives.

Main Methods:

• Retrospective review of medical records for patients diagnosed with AFM between 2016 and 2020.
• Inclusion criteria: patients seen in a multidisciplinary clinic for persistent limb weakness.

Main Results:

• Eleven out of 54 pediatric patients (20%) required assisted ventilation for acute respiratory failure.
• Eighty-one percent of those with acute respiratory failure developed chronic respiratory failure, with 56% weaned off support by 1 year.
• All patients with unilateral diaphragm impairment experienced both acute and chronic respiratory failure.

Conclusions:

• Pediatric patients with AFM frequently experience respiratory compromise and may develop chronic respiratory failure.
• Most AFM patients can be weaned from ventilatory support within a year.
• Children with unilateral diaphragm impairment typically maintain adequate ventilation without long-term ventilatory dependence.