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Acute flaccid myelitis a review of the literature
Darina Dinov1, Jeffrey R Donowitz2
1Department of Neurology, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, United States.
Abstract:
Acute flaccid myelitis (AFM) is a rare neurological disorder that first rose to national attention in 2014. This neurological disorder has a biennial presentation with every other even year being a peak year. Most patients present in childhood 5 days after a prodromal infection. Patients usually present with muscle weakness and hypo or areflexia in the summer or fall months. Clinical outcomes are variable however most patients do not improve. Currently there are no definitive prognostic factors or etiologies found. However, it is thought that enterovirus-D68 (EV-D68) could be a potential component in the pathobiology of AFM. Treatment options are limited with variable options and no consensus. Supportive therapy has been shown to be the most effective thus far. With our review of the literature, we highlight the recent growing evidence of a possible relationship between EV-D68 and AFM. Additionally, we identify the knowledge gaps in AFM with treatment and prognostic factors.
Insights
Acute flaccid myelitis (AFM) is a rare neurological disorder often seen in children. Research suggests a link between enterovirus-D68 (EV-D68) and AFM, though causes and treatments remain unclear.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Acute flaccid myelitis (AFM) is a rare neurological disorder that gained national attention in 2014.
- AFM exhibits a biennial presentation, peaking in even-numbered years, primarily affecting children following a prodromal infection.
Purpose of the Study:
- To review the current literature on acute flaccid myelitis (AFM).
- To highlight the potential role of enterovirus-D68 (EV-D68) in AFM's pathobiology.
- To identify knowledge gaps regarding AFM etiology, prognosis, and treatment.
Main Methods:
- Literature review focusing on recent evidence.
- Analysis of clinical presentations and outcomes.
- Examination of potential infectious triggers, particularly EV-D68.
Main Results:
- Most AFM patients are children presenting with muscle weakness and hypo/areflexia after an infection, typically in summer or fall.
- Clinical outcomes for AFM are variable, with most patients not recovering fully.
- Enterovirus-D68 (EV-D68) is considered a potential factor in AFM's development.
Conclusions:
- There is growing evidence suggesting a link between EV-D68 and AFM.
- Current treatment options for AFM are limited and lack consensus, with supportive therapy being the most effective.
- Further research is needed to determine definitive prognostic factors and etiologies for AFM.
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