Related Experiment Video
Updated: Jul 12, 2025
Intracerebroventricular and Intravascular Injection of Viral Particles and Fluorescent Microbeads into the Neonatal Brain
Published on: July 24, 2016
[Acute flaccid myelitis and enterovirus infection: a severe emerging disease]
Raúl Bustos B1, Franco Díaz2, Camila Cores2
1Clínica Sanatorio Alemán, Concepción, Chile.
Insights
Acute flaccid myelitis (AFM) is a severe neurological disease affecting children. Early suspicion and emergency care are crucial as AFM can rapidly lead to respiratory failure and permanent disability.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Context:
- Acute flaccid myelitis (AFM) is an emerging neuroinflammatory condition primarily affecting children.
- Characterized by acute, asymmetric limb weakness and spinal cord gray matter lesions.
- Increasing identification of AFM cases globally since 2014.
Purpose:
- To document the initial cases of a severe, emerging neurological disease in Chile.
- To highlight the clinical presentation and outcomes of AFM in pediatric patients.
- To emphasize the need for heightened clinical suspicion among pediatricians.
Summary:
- Three previously healthy children (ages 4-6) presented with acute febrile illness, respiratory symptoms, and rapid-onset asymmetric limb weakness.
- Enterovirus was detected, and MRI revealed spinal cord gray matter hyperintensity.
- Despite intensive care and immunomodulatory treatments, outcomes were severe, including quadriplegia, death, and partial recovery.
Impact:
- Reports the first cases of severe AFM in Chile, underscoring its emergence in the region.
- Stresses that AFM should be considered a medical emergency due to its rapid progression and potential for respiratory failure.
- Highlights the critical need for prompt diagnosis and management to improve patient outcomes.
Abstract:
Acute flaccid myelitis (AFM) is a neuroinflammatory disease characterized by acute asymmetric weakness of the limbs associated with lesions of the gray matter of the spinal cord. It mainly affects children and has been increasingly identified since 2014.
Objective:
To describe a severe emerging neurological disease in Chile.
Clinical Case:
Three children (2 females), previously healthy were in cluded. The age at the onset was between 4 and 6 years. All presented an acute febrile illness associated with upper respiratory symptoms, rapid onset of proximal asymmetric limb weakness, spinal fluid pleocytosis, and enterovirus isolated from nasopharyngeal swab; two patients developed tetraparesis. The MRI of the spinal cord showed T2 hyperintensity of the grey matter. The three patients were admitted to the Pediatric Intensive Care Unit (PICU), and two required mechanical ventilation. No significant improvements were observed after the use of immunomodulatory therapy and plasma ex change. At 12 months of follow-up, one case was quadriplegic and ventilator-dependent; the second died of ventricular arrhythmia in the PICU, and the third one is under rehabilitation with partial recovery.
Conclusions:
We report the first cases of this severe emerging neurological disease in our country. In a child with predominantly proximal and asymmetric acute limb paralysis, pediatricians must have a high index of suspicion for AFM. Since it can progress rapidly and lead to respiratory failure, suspected AFM should be considered a medical emergency.
Related Concept Videos
01:15Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:20Myasthenia Gravis: Overview and Treatment
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
01:14Myocarditis III: Medical Management
01:27Acute Pyelonephritis I: Introduction