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Published on: August 21, 2017
[Acute Flaccid Myelitis]
1Department of Pediatric Neurology, Fukuoka Children's Hospital.
Abstract:
Acute flaccid myelitis (AFM) is a clinical syndrome characterized by acute flaccid paralysis that predominantly affects the spinal gray matter. It occurs mainly in children and is strongly associated with enterovirus D68. Magnetic resonance imaging typically demonstrates longitudinal lesions predominantly involving the gray matter, and the cerebrospinal fluid shows mild pleocytosis. The differential diagnosis from demyelinating transverse myelitis and Guillain-Barré syndrome is crucial for appropriate clinical management. AFM is included in acute flaccid paralysis (AFP) surveillance. Prompt notification and appropriate specimen collection are essential for the early detection of poliovirus reemergence. This article reviews the current understanding of the clinical features, diagnosis, and public health significance of AFM.
Insights
Acute flaccid myelitis (AFM) is a neurological condition causing paralysis, often linked to enterovirus D68 in children. Early detection and diagnosis are vital for managing AFM and preventing poliovirus spread.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Acute flaccid myelitis (AFM) is a rare but serious neurological condition.
- It primarily affects the spinal cord's gray matter, leading to acute flaccid paralysis.
- AFM is strongly associated with enterovirus D68 infections, particularly in children.
Purpose of the Study:
- To review the current understanding of AFM's clinical features.
- To outline diagnostic approaches for AFM.
- To highlight the public health significance of AFM surveillance.
Main Methods:
- Review of current literature on AFM.
- Analysis of clinical presentation and neuroimaging findings.
- Discussion of diagnostic criteria and differential diagnoses.
Main Results:
- AFM presents with acute flaccid paralysis, predominantly affecting spinal gray matter.
- MRI shows characteristic longitudinal lesions, and CSF analysis reveals mild pleocytosis.
- Distinguishing AFM from transverse myelitis and Guillain-Barré syndrome is critical.
Conclusions:
- AFM requires prompt recognition and diagnosis for effective clinical management.
- Inclusion in acute flaccid paralysis (AFP) surveillance is essential.
- Vigilant surveillance aids in the early detection of poliovirus and other enterovirus threats.
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