Materiały źródłowe

• #1 Acute Flaccid Myelitis (AFM): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17991-acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare neurological condition that causes your muscles and reflexes to become weak. […] AFM is a relatively new diagnosis researchers first described it in 2014. […] It can be difficult for healthcare providers to diagnose AFM, as its rare and resembles other neurological conditions, such as transverse myelitis, Guillain-Barr syndrome and polio. […] Your provider will ask about your symptoms and medical history. Theyll likely perform or order several tests to help diagnose AFM and/or rule out other conditions. Tests include: […] MRI of your spinal cord and brain to look for changes in the gray matter of your spinal cord. This is the most useful test for confirming AFM. […] Theres no cure or specific treatment for acute flaccid myelitis. Instead, managing symptoms is the goal.

• #2 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/afm.html

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, causing the muscles and reflexes in the body to work abnormally. […] There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. […] Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016. […] Clinicians should collect specimens from patients suspected of having AFM as early as possible in the course of illness, preferably on the day of onset of limb weakness. Early specimen collection has the best chance to yield a diagnosis of AFM.

• #3 Acute Flaccid Myelitis (AFM): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17991-acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare neurological condition that causes your muscles and reflexes to become weak. […] AFM is a relatively new diagnosis researchers first described it in 2014. […] It can be difficult for healthcare providers to diagnose AFM, as its rare and resembles other neurological conditions, such as transverse myelitis, Guillain-Barr syndrome and polio. […] Your provider will ask about your symptoms and medical history. Theyll likely perform or order several tests to help diagnose AFM and/or rule out other conditions. Tests include: […] MRI of your spinal cord and brain to look for changes in the gray matter of your spinal cord. This is the most useful test for confirming AFM. […] Theres no cure or specific treatment for acute flaccid myelitis. Instead, managing symptoms is the goal.

• #4 Acute Flaccid Myelitis – JETem

  https://jetem.org/acute-flaccid-myelitis/

  Although a somewhat rare disease, acute flaccid myelitis (AFM) can cause death, and for those pediatric patients that survive, less than 10% have full recovery. A cluster of cases that resembled polio was first described in California in 2012. After 120 cases of the disease were confirmed in 2014 in a 5-month period, the Centers for Disease Control and Prevention (CDC) began surveillance of the disease. Since surveillance began, clusters of cases have occurred in a biennial pattern, usually late summer and early fall. There were 218 cases between 2015 to 2017, 238 cases in 2018, 47 cases in 2019, and 32 in 2020. AFM has become recognized as a global disease with cases reported across many countries. The CDC has noted that the most common location of the first medical encounter of pediatric patients presenting with AFM is the emergency department in every year that surveillance occurred. Most of the children that are diagnosed with AFM are admitted to the hospital and of those admitted, 30% require intubation. Deaths related to AFM are due to respiratory involvement and complications. With appropriate recognition and supportive care, mortality can be avoided.

• #5 Acute flaccid myelitis (AFM) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-flaccid-myelitis/symptoms-causes/syc-20493046

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord. […] If you or your child develops symptoms of acute flaccid myelitis, seek immediate medical care. Symptoms can progress rapidly. Hospitalization is needed and sometimes a ventilator is required for breathing support. […] Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. […] The symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. But none of the acute flaccid myelitis cases in the United States have been caused by poliovirus. […] Acute flaccid myelitis mainly affects young children. […] Muscle weakness caused by acute flaccid myelitis can continue for months to years. […] There’s no specific way to prevent acute flaccid myelitis. However, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis. […] Associated Procedures include Electromyography (EMG), Lumbar puncture (spinal tap), and MRI.

• #6 AFM in Pediatrics | Children’s Hospital Colorado

  https://www.childrenscolorado.org/health-professionals/professional-resources/charting-pediatrics-podcast/afm-pediatrics/

  Acute flaccid myelitis (AFM) is a rare but serious condition. AFM affects the nervous system, specifically the gray matter of the spinal cord. The result is a presentation of flaccid paralysis symptoms. AFM primarily affects children. Experts believe that AFM is most often caused by viruses. Enterovirus D68 (EV-D68), a member of the polio family, is the most likely culprit behind AFM cases in the United States. […] The specimens required to make an accurate AFM diagnosis. […] Children’s Colorado doctors recognized the first cluster of AFM in 2014 and were able to study the virus with colleagues from the University of Colorado School of Medicine.

• #7 Acute flaccid myelitis (AFM) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-flaccid-myelitis/symptoms-causes/syc-20493046

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord. […] If you or your child develops symptoms of acute flaccid myelitis, seek immediate medical care. Symptoms can progress rapidly. Hospitalization is needed and sometimes a ventilator is required for breathing support. […] Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. […] The symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. But none of the acute flaccid myelitis cases in the United States have been caused by poliovirus. […] Acute flaccid myelitis mainly affects young children. […] Muscle weakness caused by acute flaccid myelitis can continue for months to years. […] There’s no specific way to prevent acute flaccid myelitis. However, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis. […] Associated Procedures include Electromyography (EMG), Lumbar puncture (spinal tap), and MRI.

• #8 Mayo Clinic Health Library – Acute flaccid myelitis (AFM) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20491145

  To diagnose acute flaccid myelitis, the doctor starts with a thorough medical history and physical exam. The doctor might recommend: […] Acute flaccid myelitis can be hard to diagnose because it shares many of the same symptoms as other neurological diseases, such as Guillain-Barre syndrome. These tests can help distinguish acute flaccid myelitis from other conditions.

• #9 Acute Flaccid Myelitis (AFM) | Peter O’Donnell Jr. Brain Institute | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/acute-flaccid-myelitis-afm/

  Diagnosing AFM can be difficult because its symptoms resemble those of other neurological conditions, such as transverse myelitis, vascular myelopathy, or Guillain-Barr syndrome. […] There is no specific treatment for AFM, and its long-term outcomes aren’t known. Some people completely recover, while others continue to have muscle weakness and symptoms for more than a year. Some therapies can help relieve symptoms and support recovery. […] At UT Southwestern, our neurologists develop a customized treatment plan based on each patient’s specific symptoms and overall health.

• #10 Acute flaccid myelitis: cause, diagnosis, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/33357469/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. […] The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. […] There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. […] Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. […] In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. […] Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host-virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.

• #11 Understanding How AFM is Diagnosed | Acute Flaccid Myelitis (AFM) | CDC

  https://www.cdc.gov/acute-flaccid-myelitis/helping-children/surveillance.html

  Clinicians diagnose AFM by taking a thorough medical history of the patient, doing a physical exam, and performing a magnetic resonance imaging (MRI) to review pictures of the spinal cord. […] When a clinician suspects or diagnoses AFM, they report the case to the state health department. […] Some patients may have an AFM diagnosis from their clinician, but do not meet all the classification criteria for a confirmed or probable case. […] Clinicians should not wait for CDC’s case classification to diagnose AFM. […] AFM diagnosis is done by a clinician. […] AFM diagnosis is done by examining the nervous system in combination with reviewing the MRI (pictures of the spinal cord). […] AFM diagnosis is meant to get the patient into medical treatment and care. […] AFM diagnosis is independent from CDC’s case classification.

• #12 Acute Flaccid Myelitis

  https://www.aap.org/en/patient-care/acute-flaccid-myelitis/?srsltid=AfmBOopaBmED_axQyjkc-_63U4ki9mjGNPQTTbZ96RJTtcsgOLFmiLNy

  Acute flaccid myelitis (AFM) is a rare but serious neurological illness that causes muscle weakness, sometimes leading to paralysis. Early detection and collection of specimens can help identify cases and causes of AFM. […] Early detection and medical support are critical to improve long-term health outcomes of children with AFM. Delays in recognition can put children at risk. Pediatricians and pediatric health care providers who can identify AFM and promptly hospitalize patients are best positioned to provide optimal medical care.

• #13 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Consider AFM in patients presenting with rapid-onset weakness (period from onset to nadir: hours to 10 days approximately), particularly when occurring during or shortly after a suspected viral illness or fever. […] The clinical syndrome of AFM is defined by acute onset of limb weakness with lower motor neuron findings evident on exam. As such, conducting a complete neurological examination is the most important aspect of the initial clinical assessment. […] MRI of the spinal cord is the most useful diagnostic test in AFM and should be prioritized. Include cervical, thoracic, and lumbar spine, with T2 and T1 pre- and post-contrast sequences in both axial and sagittal planes. […] The characteristic MRI abnormality is gray-matter predominant T2 hyperintensity of the spinal cord with associated spinal cord edema; lesion(s) are usually longitudinally-extensive and non-enhancing.

• #14 Acute Flaccid Myelitis: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare neurological condition that can cause paralysis. […] Below, well go into more detail about AFM, including its symptoms and causes, as well as how doctors diagnose and treat it. […] The diagnosis of AFM can be tricky. Not only is it rare overall, but its symptoms can be similar to other neurological conditions, including, but not limited to: polio, Guillain-Barre syndrome, transverse myelitis, multiple sclerosis, acute disseminated encephalomyelitis. […] Getting a thorough medical history is important. In addition to evaluating your symptoms, a doctor will note things like age, time of year, and if you have a recent history of illness with fever. […] They can also do the following tests to help confirm a diagnosis of AFM: Physical exam: During this exam, your doctor will look for areas with reduced muscle tone and weakness.

• #15 Acute Flaccid Myelitis (AFM) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare but serious nerve-related condition that attacks the spinal cord and the nerves that go to the muscles. […] Patient history is very important for diagnosis of AFM. The doctor will want to know if your child has had a recent cold such as a fever, cough or upset stomach. […] A detailed physical exam is very important, but the MRI of the spine is usually used to diagnosis AFM and lab tests of the cerebral spinal fluid (CSF) and blood may be performed and can also help make the diagnosis of AFM.

• #16 Acute flaccid myelitis

  https://www.ucsfbenioffchildrens.org/medical-tests/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is usually caused by infection with a virus. […] Your health care provider will take your medical history and vaccination history to know if you are up-to-date with your polio vaccines. Unvaccinated individuals who are exposed to poliovirus are at higher risk for acute flaccid myelitis. […] Tests that may be done include: MRI of spine and MRI of the brain to view lesions in the gray matter, Nerve conduction velocity test, Electromyography (EMG), Cerebrospinal fluid (CSF) analysis to check if white blood cells are elevated. […] There is no specific treatment for AFM. You may be referred to a doctor specializing in disorders of the nerves and nervous system (neurologist). […] Having a polio vaccine may help reduce the risk of AFM related to the poliovirus.

• #17 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Consider AFM in patients presenting with rapid-onset weakness (period from onset to nadir: hours to 10 days approximately), particularly when occurring during or shortly after a suspected viral illness or fever. […] The clinical syndrome of AFM is defined by acute onset of limb weakness with lower motor neuron findings evident on exam. As such, conducting a complete neurological examination is the most important aspect of the initial clinical assessment. […] MRI of the spinal cord is the most useful diagnostic test in AFM and should be prioritized. Include cervical, thoracic, and lumbar spine, with T2 and T1 pre- and post-contrast sequences in both axial and sagittal planes. […] The characteristic MRI abnormality is gray-matter predominant T2 hyperintensity of the spinal cord with associated spinal cord edema; lesion(s) are usually longitudinally-extensive and non-enhancing.

• #18 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] A good clinical examination, an MRI of the spinal cord, and the analysis of cerebrospinal fluid are essential tests that help diagnose AFM and differentiate it from other conditions that can cause a similar presentation. […] A complete and thorough neurological exam is essential for diagnosis. Exam findings suggestive of AFM include weakness involving one or more limbs, decreased muscle tone, and decreased reflexes in the affected limbs. […] Regarding MRI findings, lesions on the grey matter of the spinal cord, usually involving several vertebral levels, are the characteristic abnormality in AFM. […] A lumbar puncture should also be completed in suspected cases. It usually reveals a moderate increase in white blood cells and mild protein elevation.

• #19 NC DPH: Acute Flaccid Myelitis (AFM)

  https://epi.dph.ncdhhs.gov/cd/diseases/afm.html

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, which can result from a variety of causes including viral infections. AFM is characterized by a sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes. Numbness or other physical symptoms are rare, although some patients may have pain in their arms or legs. In some cases, dysfunction of the nerves controlling the head and neck, resulting in such features as facial weakness, difficulty swallowing, or drooping of the eyelids, may accompany the limb weakness. […] A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system, looking at the location of the weakness, muscle tone, and reflexes, to help differentiate such patients from patients with other forms of acute flaccid paralysis (AFP). Magnetic resonance imaging (MRI) can be very helpful in diagnosing cases of AFM.

• #20 NC DPH: Acute Flaccid Myelitis (AFM)

  https://epi.dph.ncdhhs.gov/cd/diseases/afm.html

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, specifically the spinal cord, which can result from a variety of causes including viral infections. AFM is characterized by a sudden weakness in one or more arms or legs, along with loss of muscle tone and decreased or absent reflexes. Numbness or other physical symptoms are rare, although some patients may have pain in their arms or legs. In some cases, dysfunction of the nerves controlling the head and neck, resulting in such features as facial weakness, difficulty swallowing, or drooping of the eyelids, may accompany the limb weakness. […] A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system, looking at the location of the weakness, muscle tone, and reflexes, to help differentiate such patients from patients with other forms of acute flaccid paralysis (AFP). Magnetic resonance imaging (MRI) can be very helpful in diagnosing cases of AFM.

• #21 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Consider AFM in patients presenting with rapid-onset weakness (period from onset to nadir: hours to 10 days approximately), particularly when occurring during or shortly after a suspected viral illness or fever. […] The clinical syndrome of AFM is defined by acute onset of limb weakness with lower motor neuron findings evident on exam. As such, conducting a complete neurological examination is the most important aspect of the initial clinical assessment. […] MRI of the spinal cord is the most useful diagnostic test in AFM and should be prioritized. Include cervical, thoracic, and lumbar spine, with T2 and T1 pre- and post-contrast sequences in both axial and sagittal planes. […] The characteristic MRI abnormality is gray-matter predominant T2 hyperintensity of the spinal cord with associated spinal cord edema; lesion(s) are usually longitudinally-extensive and non-enhancing.

• #22 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Consider AFM in patients presenting with rapid-onset weakness (period from onset to nadir: hours to 10 days approximately), particularly when occurring during or shortly after a suspected viral illness or fever. […] The clinical syndrome of AFM is defined by acute onset of limb weakness with lower motor neuron findings evident on exam. As such, conducting a complete neurological examination is the most important aspect of the initial clinical assessment. […] MRI of the spinal cord is the most useful diagnostic test in AFM and should be prioritized. Include cervical, thoracic, and lumbar spine, with T2 and T1 pre- and post-contrast sequences in both axial and sagittal planes. […] The characteristic MRI abnormality is gray-matter predominant T2 hyperintensity of the spinal cord with associated spinal cord edema; lesion(s) are usually longitudinally-extensive and non-enhancing.

• #23 Acute flaccid myelitis: cause, diagnosis, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7909727/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. […] The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. […] There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. […] The diagnosis of AFM can be informed by interpretation of the clinical features alongside findings of laboratory, neuroimaging, and electrophysiological tests. […] MRI of the spinal cord is the most useful diagnostic test in AFM. T2 hyperintensity of the spinal cord grey matter is the hallmark of AFM. […] CSF pleocytosis is identified in almost all patients with AFM undergoing lumbar puncture in the acute phase, with a mild to moderate elevation in white blood cell count (usually 100 per L with lymphocytic predominance), which appears to resolve over subsequent weeks.

• #24 Acute flaccid myelitis (AFM) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/acute-flaccid-myelitis-afm

  A diagnosis of acute flaccid myelitis can be made with the observation of weakness of the limbs, decreased reflexes and poor muscle tone on exam. Evidence of injury to the spinal cord can be confirmed using a magnetic resonance imaging (MRI) scan. A distinctive pattern is seen in the spinal cord, with a butterfly-shaped pattern of abnormality affecting the gray matter. Cerebrospinal fluid (CSF) testing is typically done to search for infections and rule out other causes. […] To date, there have been no controlled studies of medical treatments for AFM. Intravenous immunoglobulin (IVIG) may be used to try to build up the bodys resistance to viruses. Medications typically used for the treatment of transverse myelitis (TM), including steroids and plasma exchange, have been tried in AFM with mixed results. […] At Childrens Hospital of Philadelphia, we are actively engaged in research to better understand the function and causes of AFM and to identify more effective treatments.

• #25 Acute Flaccid Myelitis (AFM) | Diagnosis | SRNA

  https://wearesrna.org/living-with-myelitis/disease-information/acute-flaccid-myelitis/diagnosis/

  Acute flaccid myelitis is diagnosed based upon clinical exam, magnetic resonance imaging (MRI) of the spinal cord, and analysis of cerebrospinal fluid (CSF) (usually with increased white blood cells or pleocytosis). […] On MRI of the spinal cord, AFM lesions are longitudinal throughout the grey matter (the anterior horn cells). […] Sometimes imaging may appear normal early in the disease, but repeat imaging shows the lesions. […] In some situations, electrophysiological studies of the nerves and muscle (called nerve conduction and electromyogram [NCS/EMG]) may help to determine if there is injury to the lower motor neuron. […] Testing may also include blood draws, respiratory tract samples, or collection of other bodily fluids to determine if a viral or infectious cause is present.

• #26 Acute flaccid myelitis | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/acute-flaccid-myelitis/

  In AFM, the grey matter in the spinal cord is damaged which interferes with message transmission to and from the brain, leading to sudden weakness. […] It is important to take your child to the doctor if they develop any sudden weakness. Identifying AFM quickly and starting treatment can reduce the risk of complications from serious problems such as when breathing is affected. […] A lumbar puncture is needed to collect a sample of cerebrospinal fluid (CSF) from around the spinal cord this is then examined in our laboratory. Children with AFM usually have more cells than usual in their CSF. It is also important to analyse the fluid for other viruses. […] A magnetic resonance imaging (MRI) scan of the spinal cord which may show areas of damage affecting the grey matter of the spine. Early on the MRI can be normal, so it may need to be repeated after a few days. […] Electromyography (EMG) and Nerve Conduction studies (NCS) may be carried out to look at how well the message is being sent along the nerve and to try to see where the problem lies.

• #27 Acute flaccid myelitis: cause, diagnosis, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7909727/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. […] The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. […] There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. […] The diagnosis of AFM can be informed by interpretation of the clinical features alongside findings of laboratory, neuroimaging, and electrophysiological tests. […] MRI of the spinal cord is the most useful diagnostic test in AFM. T2 hyperintensity of the spinal cord grey matter is the hallmark of AFM. […] CSF pleocytosis is identified in almost all patients with AFM undergoing lumbar puncture in the acute phase, with a mild to moderate elevation in white blood cell count (usually 100 per L with lymphocytic predominance), which appears to resolve over subsequent weeks.

• #28 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] A good clinical examination, an MRI of the spinal cord, and the analysis of cerebrospinal fluid are essential tests that help diagnose AFM and differentiate it from other conditions that can cause a similar presentation. […] A complete and thorough neurological exam is essential for diagnosis. Exam findings suggestive of AFM include weakness involving one or more limbs, decreased muscle tone, and decreased reflexes in the affected limbs. […] Regarding MRI findings, lesions on the grey matter of the spinal cord, usually involving several vertebral levels, are the characteristic abnormality in AFM. […] A lumbar puncture should also be completed in suspected cases. It usually reveals a moderate increase in white blood cells and mild protein elevation.

• #29 Acute flaccid myelitis (AFM) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/acute-flaccid-myelitis-afm

  A diagnosis of acute flaccid myelitis can be made with the observation of weakness of the limbs, decreased reflexes and poor muscle tone on exam. Evidence of injury to the spinal cord can be confirmed using a magnetic resonance imaging (MRI) scan. A distinctive pattern is seen in the spinal cord, with a butterfly-shaped pattern of abnormality affecting the gray matter. Cerebrospinal fluid (CSF) testing is typically done to search for infections and rule out other causes. […] To date, there have been no controlled studies of medical treatments for AFM. Intravenous immunoglobulin (IVIG) may be used to try to build up the bodys resistance to viruses. Medications typically used for the treatment of transverse myelitis (TM), including steroids and plasma exchange, have been tried in AFM with mixed results. […] At Childrens Hospital of Philadelphia, we are actively engaged in research to better understand the function and causes of AFM and to identify more effective treatments.

• #30 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Electromyography and Nerve Conduction Studies (EMG/NCS) are valuable tools in the investigation of neuromuscular disorders, and every day we learn more about its uses in AFM. Current cases reported show some degree of motor neuropathy, evidenced by diminished compound motor action potential (CMAP) amplitudes, and reduced voluntary motor unit potential (MUP) recruitment, with the absence of sensory nerve conduction abnormalities. […] Taking into account the previously outlined elements of clinical history (H), examination (E), neuroimaging (NI), and CSF analysis (CSF), we propose the following diagnostic criteria for AFM. […] These consensus diagnostic criteria are designed to be applied in the acute phase of the illness to classify the level of certainty of a diagnosis of AFM and to help distinguish AFM from other causes of acute flaccid paralysis.

• #31 NC DPH: Acute Flaccid Myelitis (AFM)

  https://epi.dph.ncdhhs.gov/cd/diseases/afm.html

  Testing nerve response can also be helpful in supporting a diagnosis of AFM; it is important that the tests are performed at the appropriate time (e.g., 7-10 days after onset of weakness) to be helpful. Finally, by testing the cerebrospinal fluid (CSF, the fluid bathing the brain and spinal cord), clinicians can look for findings suggestive of AFM. All of these findings put together help a clinician make a diagnosis of AFM.

• #32 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Electromyography and Nerve Conduction Studies (EMG/NCS) are valuable tools in the investigation of neuromuscular disorders, and every day we learn more about its uses in AFM. Current cases reported show some degree of motor neuropathy, evidenced by diminished compound motor action potential (CMAP) amplitudes, and reduced voluntary motor unit potential (MUP) recruitment, with the absence of sensory nerve conduction abnormalities. […] Taking into account the previously outlined elements of clinical history (H), examination (E), neuroimaging (NI), and CSF analysis (CSF), we propose the following diagnostic criteria for AFM. […] These consensus diagnostic criteria are designed to be applied in the acute phase of the illness to classify the level of certainty of a diagnosis of AFM and to help distinguish AFM from other causes of acute flaccid paralysis.

• #33 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  Studies of the nerves and muscle conductions (called nerve conduction and electromyography [NCS/EMG]) can also be helpful in differentiating AFM from neuromuscular disorders, like botulism and Guillain Barre. […] Finally, respiratory samples should be collected and sent for viral testing. The collection of other samples, like stool, can also help determine the presence of a viral causative agent.

• #34 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/afm.html

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, causing the muscles and reflexes in the body to work abnormally. […] There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. […] Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016. […] Clinicians should collect specimens from patients suspected of having AFM as early as possible in the course of illness, preferably on the day of onset of limb weakness. Early specimen collection has the best chance to yield a diagnosis of AFM.

• #35 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/Acute-Flaccid-Myelitis.aspx

  Clinicians should report any person with onset of acute flaccid limb weakness to their local health department (LHD) regardless of laboratory testing or MRI results. […] Collect specimens for suspect cases as early as possible in the course of illness, preferably on the day of limb weakness onset, to increase the chance of virus detection. […] VRDL will perform molecular testing for SARS-CoV-2, enterovirus, rhinovirus, and adenovirus. VRDL will also perform serologic testing for West Nile virus (during transmission season May-December), St. Louis encephalitis virus (SLEV) (in counties with SLEV environmental detection), and Zika, Dengue, and Chikungunya viruses (if indicated by travel history). […] The CDC recommends standard, contact and droplet precautions for suspected or confirmed AFM cases.

• #36 Acute Flaccid Myelitis – Child Neurology Foundation

  https://www.childneurologyfoundation.org/disorder/acute-flaccid-myelitis/

  Acute flaccid myelitis (AFM) is a disease that affects the spinal cord and brainstem. It causes weakness in one or more limbs. […] AFM is thought to be caused by a virus that also causes a respiratory illness. AFM is similar to poliomyelitis (polio). However, it is caused by a different virus. […] The following are used to diagnose AFM: […] An MRI of the brain and spinal cord is taken. This will show swelling or lesions in a specific area of the spinal cord and/or brainstem. […] An LP is commonly referred to as a spinal tap. This test involves taking a sample of cerebrospinal fluid (CSF). […] A swab will be taken to test for respiratory viruses. These include enterovirus D68 and enterovirus A71. […] A stool sample and/or rectal swab will be taken to test for viruses. […] Sometimes, a nerve conduction study will be used to measure electrical activity in nerves. In nerves coming from the spinal cord affected by AFM, electrical activity can be decreased in a particular pattern.

• #37 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  Studies of the nerves and muscle conductions (called nerve conduction and electromyography [NCS/EMG]) can also be helpful in differentiating AFM from neuromuscular disorders, like botulism and Guillain Barre. […] Finally, respiratory samples should be collected and sent for viral testing. The collection of other samples, like stool, can also help determine the presence of a viral causative agent.

• #38 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/afm.html

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, causing the muscles and reflexes in the body to work abnormally. […] There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. […] Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016. […] Clinicians should collect specimens from patients suspected of having AFM as early as possible in the course of illness, preferably on the day of onset of limb weakness. Early specimen collection has the best chance to yield a diagnosis of AFM.

• #39 Diagnostic Approaches | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/healthcare-providers/diagnostic-approaches/

  Electromyography and Nerve Conduction Studies (EMG/NCS) are valuable tools in the investigation of neuromuscular disorders, and every day we learn more about its uses in AFM. Current cases reported show some degree of motor neuropathy, evidenced by diminished compound motor action potential (CMAP) amplitudes, and reduced voluntary motor unit potential (MUP) recruitment, with the absence of sensory nerve conduction abnormalities. […] Taking into account the previously outlined elements of clinical history (H), examination (E), neuroimaging (NI), and CSF analysis (CSF), we propose the following diagnostic criteria for AFM. […] These consensus diagnostic criteria are designed to be applied in the acute phase of the illness to classify the level of certainty of a diagnosis of AFM and to help distinguish AFM from other causes of acute flaccid paralysis.

• #40 Acute flaccid myelitis: cause, diagnosis, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7909727/

  The diagnosis of AFM can be considered definite when characteristic MRI findings and CSF pleocytosis are present in addition to the previously mentioned core clinical features. […] The diagnosis of AFM can be considered probable when the core clinical features and characteristic MRI findings are present, but CSF pleocytosis is absent (or not checked). […] The diagnosis of AFM can be considered possible in cases with a limited or milder clinical syndrome, with characteristic MRI findings; and uncertain when the core clinical features are present, but without adequate MRI studies to evaluate.

• #41 Acute flaccid myelitis: cause, diagnosis, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7909727/

  The diagnosis of AFM can be considered definite when characteristic MRI findings and CSF pleocytosis are present in addition to the previously mentioned core clinical features. […] The diagnosis of AFM can be considered probable when the core clinical features and characteristic MRI findings are present, but CSF pleocytosis is absent (or not checked). […] The diagnosis of AFM can be considered possible in cases with a limited or milder clinical syndrome, with characteristic MRI findings; and uncertain when the core clinical features are present, but without adequate MRI studies to evaluate.

• #42 Acute Flaccid Myelitis | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/afm.htm

  Acute flaccid myelitis (AFM) is also called acute flaccid paralysis with anterior myelitis or polio-like syndrome. […] AFM is often hard to diagnose. Providers look at the nervous system, location of muscle weakness, reflexes, and muscle firmness. […] Magnetic resonance imaging (MRI), tests of cerebrospinal fluid (CSF), and electromyography (EMG) nerve tests can be done to test for other illnesses or complications. […] There is no specific treatment for AFM. The treatment depends on the individual. […] An illness with onset of acute flaccid limb weakness (AFM case definition) […] Confirmatory Laboratory Evidence: a magnetic resonance image (MRI) showing spinal cord lesion largely restricted to gray matter and spanning one or more vertebral segments. […] Supportive Laboratory Evidence: cerebrospinal fluid (CSF) with pleocytosis (white blood cell count 5 cells/mm3).

• #43 Acute Flaccid Myelitis | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/afm.htm

  Clinically compatible case and confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to gray matter and spanning one or more spinal segments. […] Clinically compatible case and supportive laboratory evidence: CSF showing pleocytosis (white blood cell count 5 cells/mm3).

• #44 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Acute-Flaccid-Myelitis-Causes-and-Diagnosis.aspx

  Acute flaccid myelitis (AFM) is a medical condition characterized by muscular weakness and myelitis, which is the medical term used to describe inflammation of the spinal cord. […] The symptoms associated with AFM are often similar to other neurological conditions, such as transverse myelitis and Guillain-Barre syndrome (GBS). This makes differential diagnosis of AFM difficult. However, certain tests and neurological examination may aid prompt diagnosis of the condition. […] Typical diagnosis strategy includes complete physical examination, magnetic resonance imaging (MRI), cerebral spinal fluid (CSF) testing, electromyography or electrodiagnostic tests, and nerve conduction velocity tests. […] As per the Centers for Disease Control and Prevention (CDC), the diagnosis of AFM requires two criteria: Acute asymmetric flaccid paralysis characterized with weakness, and lesions specifically in the gray matter of the brain in MRI scan comprising of one or more spinal segments.

• #45 Acute Flaccid Myelitis: A Modern-day Polio?

  https://consultqd.clevelandclinic.org/acute-flaccid-myelitis-a-modern-day-polio

  Acute flaccid myelitis (AFM) is a recently described rare condition primarily affecting otherwise healthy children. It is characterized by muscle weakness and myelitis of the spinal cords anterior horn cells following a viral illness. […] When making the diagnosis of AFM, many tests are frequently ordered, but they rarely help the clinician. Lumbar punctures will frequently demonstrate pleocytosis (74 percent) and some protein elevation (48 percent), but rarely yield an infectious organism. […] Current Centers for Disease Control and Prevention (CDC) definitions of AFM require two criteria: acute onset of flaccid limb weakness and MRI evidence of a gray matter lesion spanning one or more spinal segments. […] A lumbar puncture demonstrating pleocytosis can make the diagnosis of AFM probable when in combination with acute-onset limb flaccid weakness, but is not definitive for the condition. […] Timely recognition of AFM and referral to a center familiar with AFM is essential to prevent this disease from becoming a 21st century resurrection of polio.

• #46 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/afm.html

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, causing the muscles and reflexes in the body to work abnormally. […] There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. […] Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016. […] Clinicians should collect specimens from patients suspected of having AFM as early as possible in the course of illness, preferably on the day of onset of limb weakness. Early specimen collection has the best chance to yield a diagnosis of AFM.

• #47

  https://hip.phila.gov/disease-control/diseasesconditions/acute-flaccid-myelitis/

  Acute Flaccid Myelitis: Recognition, Testing, and Reporting Requirements […] If AFM is suspected, specimen collection should occur as early as possible, ideally on the day of limb weakness onset. […] Report any illness to PDPH that meets all of the current Council of State and Territorial Epidemiologists (CSTE) case definition criteria: A person with acute onset of focal limb weakness, AND a magnetic resonance image showing a spinal cord lesion largely restricted to gray matter, and spanning one or more vertebral segments OR Cerebrospinal fluid (CSF) with pleocytosis (CSF white blood cell count 5 cells/mm3); CSF protein may or may not be elevated. […] Spinal cord lesions may not be present on initial MRI; a negative or normal MRI performed within the first 72 hours after onset of limb weakness does not rule out AFM. […] Providers should also remember to routinely report any patient (suspected or confirmed) with the following conditions and infections that cause neurologic symptoms to PDPH.

• #48 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/Acute-Flaccid-Myelitis.aspx

  In 2012, CDPH began receiving reports of patients with an unusual condition called acute flaccid myelitis (AFM). Since then, there have been statewide and nationwide spikes in AFM cases noted in the summer and fall months of 2014, 2016 and 2018. […] AFM patients are primarily children, although cases have also been reported in adults. Symptoms typically include a preceding febrile respiratory illness followed by sudden onset of limb weakness and loss of muscle tone and reflexes. In addition to limb weakness, some patients have cranial nerve involvement and present with facial droop/weakness, difficulty moving the eyes, drooping eyelids, or difficulty with swallowing or slurred speech. […] Although a definitive cause for AFM has not yet been established, experts think many cases are due to viral causes, which include non-polio enteroviruses (EV-D68, EV-A71), flaviviruses (West Nile virus, Japanese encephalitis virus), herpesviruses, and adenoviruses. To better understand the potential causes, optimal treatment, and outcomes of AFM, CDPH is conducting enhanced surveillance for AFM cases. Enhanced surveillance includes viral testing at CDPH Viral and Rickettsial Diseases Laboratory (VRDL) to identify causes of AFM.

• #49 Acute Flaccid Myelitis (AFM)

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/afm.html

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, causing the muscles and reflexes in the body to work abnormally. […] There is no specific treatment for AFM, but a neurologist may recommend certain interventions on a case-by-case basis. […] Clinicians suspecting AFM in patients meeting the probable or confirmed case definition (irrespective of laboratory testing results) are asked to report these cases to the local health department governing the jurisdiction where the patient lives, or to the Illinois Department of Public Health Communicable Disease Control Section at 217-782-2016. […] Clinicians should collect specimens from patients suspected of having AFM as early as possible in the course of illness, preferably on the day of onset of limb weakness. Early specimen collection has the best chance to yield a diagnosis of AFM.

• #50 Acute Flaccid Myelitis (AFM) | Peter O’Donnell Jr. Brain Institute | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/acute-flaccid-myelitis-afm/

  Diagnosing AFM can be difficult because its symptoms resemble those of other neurological conditions, such as transverse myelitis, vascular myelopathy, or Guillain-Barr syndrome. […] There is no specific treatment for AFM, and its long-term outcomes aren’t known. Some people completely recover, while others continue to have muscle weakness and symptoms for more than a year. Some therapies can help relieve symptoms and support recovery. […] At UT Southwestern, our neurologists develop a customized treatment plan based on each patient’s specific symptoms and overall health.

• #51 Pediatric Acute Flaccid Myelitis – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. […] Doctors typically diagnose acute flaccid myelitis by reviewing a patients medical history, examining their nervous system and performing an MRI to view pictures of the spinal cord. […] Acute flaccid myelitis can be difficult to diagnose because it shares many of the same symptoms as other neurologic diseases, such as stroke and Guillain-Barre syndrome, which also need prompt treatment. […] Currently, there is no specific treatment for acute flaccid myelitis, but doctors may recommend different treatments based on each patient. […] Research is underway to improve understanding of acute flaccid myelitis and develop better treatments.

• #52 Acute Flaccid Myelitis – JETem

  https://jetem.org/acute-flaccid-myelitis/

  The educational content effectiveness was two-fold. The content was effective for teaching the presentation and appropriate evaluation to diagnose AFM. AFM is significantly like the presentation of poliomyelitis which originally occurred in sporadic cluster outbreaks and then the number of cases in the United States doubled every 4-5 years from 1940-1952. AFM is a disease that occurs in a biennial pattern and needs to be recognized and reported appropriately. AFM requires an MRI with specific abnormalities to meet the case definition while an MRI can be performed when GBS is suspected, but it is not necessary. AFM MRI abnormalities demonstrate brainstem and spinal cord lesions with a predominance of gray matter affected while a GBS MRI demonstrates ventral root abnormalities without any spinal cord or brainstem lesions. Without the MRI results, a patient may be assigned the incorrect diagnosis upon admission. A lumbar puncture and electromyography are required for the diagnosis of GBS. The cerebrospinal fluid (CSF) of GBS demonstrates high protein levels and white blood cell count (WBC) 10 cells/mm3 while the CSF of AFM demonstrates pleocytosis although usually 100 cells/mm3. Electromyography will be abnormal in both GBS and AFM, but the test is not necessary for the diagnosis of AFM as it is with GBS. Reaching the appropriate diagnosis allows the emergency medicine physician to communicate more accurately with worried parents, providing them with correct information on treatment and progression of the disease.

• #53 :: JCN :: Journal of Clinical Neurology

  https://thejcn.com/DOIx.php?id=10.3988/jcn.2020.16.3.376

  Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. […] Acute flaccid paralysis (AFP) is the long-known limb paralytic syndrome caused by a viral pathogen. AFM is a subset of AFP that is also characterized by a limb paralytic condition, but it has certain distinct features such as lesions in magnetic resonance imaging of the spinal cord gray matter. […] The criteria of the Center for Disease Control and Prevention (CDC) for the AFM diagnosis include MRI with evidence of a spinal cord gray-matter lesion that spans at least one spinal segment. […] An accurate diagnosis for distinguishing AFM from other analogous neurological conditions is critical for the appropriate clinical intervention and management of AFM patients in the clinic.

• #54 Acute Flaccid Myelitis – JETem

  https://jetem.org/acute-flaccid-myelitis/

  Although a somewhat rare disease, acute flaccid myelitis (AFM) can cause death, and for those pediatric patients that survive, less than 10% have full recovery. A cluster of cases that resembled polio was first described in California in 2012. After 120 cases of the disease were confirmed in 2014 in a 5-month period, the Centers for Disease Control and Prevention (CDC) began surveillance of the disease. Since surveillance began, clusters of cases have occurred in a biennial pattern, usually late summer and early fall. There were 218 cases between 2015 to 2017, 238 cases in 2018, 47 cases in 2019, and 32 in 2020. AFM has become recognized as a global disease with cases reported across many countries. The CDC has noted that the most common location of the first medical encounter of pediatric patients presenting with AFM is the emergency department in every year that surveillance occurred. Most of the children that are diagnosed with AFM are admitted to the hospital and of those admitted, 30% require intubation. Deaths related to AFM are due to respiratory involvement and complications. With appropriate recognition and supportive care, mortality can be avoided.

• #55 Acute Flaccid Myelitis (AFM) Diagnosis & Treatment

  https://www.gillettechildrens.org/conditions-care/acute-flaccid-myelitis-afm

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. AFM happens when swelling in the spinal cord causes the muscles and reflexes in the body to become weak. […] How is acute flaccid myelitis (AFM) diagnosed and treated? A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system, looking at the location of the weakness, muscle tone, and reflexes. Magnetic resonance imaging (MRI) can be very helpful in diagnosing cases of AFM. Laboratory tests on biological specimens, including cerebrospinal fluid (CSF), might be needed to confirm the virus responsible for AFM. […] Currently, there is no specific treatment or vaccine for AFM, but a doctor who specializes in treating brain and spinal cord illnesses (neurologist) might recommend certain treatments on a case-by-case basis. […] Early physical and rehabilitative therapy for children who have AFM might be beneficial in preventing muscle loss, joint rigidity and might improve functional outcomes. […] Gillette offers comprehensive treatment for the symptoms of AFM, from rehabilitative therapy to nerve transplant surgery.

• #56 Acute Flaccid Myelitis (AFM) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/acute-flaccid-myelitis

  Acute flaccid myelitis can be difficult to diagnose because it shares symptoms with neurologic conditions like Guillain-Barré syndrome and acute transverse myelitis. To diagnose AFM, your doctor will review your child’s medical history and examine their nervous system. Your child may also need magnetic resonance imaging (MRI) to create two- and three-dimensional images of their brain and spinal cord. […] Your doctor may test the fluid around your child’s brain and spine (cerebrospinal fluid) or check the impulses in the nervous system (nerve conduction). It’s important to consult a neurologist and infectious disease doctor when diagnosing AFM. […] There is no specific treatment at this time for acute flaccid myelitis. Your child’s doctor may recommend intravenous immunoglobulin (IVIG) or other medications. Your doctor may also recommend surgery to replace the function of the damaged nerves. In nerve transfer surgery, an orthopedic surgeon transfers healthy nerves to take over the function of the nerves damaged by the virus. In tendon transfer surgery, nearby unaffected muscles are moved to take over the muscles that are weak due to the virus.

• #57 Acute flaccid myelitis (AFM) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-flaccid-myelitis/symptoms-causes/syc-20493046

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord. […] If you or your child develops symptoms of acute flaccid myelitis, seek immediate medical care. Symptoms can progress rapidly. Hospitalization is needed and sometimes a ventilator is required for breathing support. […] Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. […] The symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. But none of the acute flaccid myelitis cases in the United States have been caused by poliovirus. […] Acute flaccid myelitis mainly affects young children. […] Muscle weakness caused by acute flaccid myelitis can continue for months to years. […] There’s no specific way to prevent acute flaccid myelitis. However, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis. […] Associated Procedures include Electromyography (EMG), Lumbar puncture (spinal tap), and MRI.

• #58 Acute flaccid myelitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/acute-flaccid-myelitis?lang=us

  Acute flaccid myelitis is an uncommon cause of acute flaccid paralysis similar to poliomyelitis, primarily affecting children and usually seen following a respiratory viral illness. […] Affected individuals typically have a respiratory viral prodrome 1 to 4 weeks before the acute neurological phase characterized by rapid onset of lower motor neuron pattern weakness in one or more limbs. […] MRI of the spinal cord demonstrates longitudinally extensive spinal cord lesions with increased T2 signal in the grey matter, particularly the anterior horns. […] Treatment is primarily supportive with no active treatment being shown to definitely improve long-term outcomes. […] The prognosis is guarded with only 5% of affected individuals reporting complete recovery.

• #59

  https://scholars.duke.edu/publication/1554198

  Acute flaccid myelitis (AFM) is a devastating neurologic condition in children, manifesting as acute limb weakness and/or paralysis. […] The purpose of this systematic review was to summarize the most current knowledge regarding AFM epidemiology, cause, clinical features, diagnosis, and supportive and operative management, including nerve transfer. […] Included articles reported on (1) AFM diagnosis and (2) patient-specific data regarding epidemiology, cause, clinical features, diagnostic features, or management of AFM. […] Clinical presentation typically comprises preceding viral prodrome, pleocytosis, spinal cord lesions on T2-weighted magnetic resonance imaging, and acute onset of flaccid weakness/paralysis with hyporeflexia in at least one extremity. […] For patients with persistent limb weakness, nerve transfer has shown promise for improving function in distal muscle groups.

• #60 Acute Flaccid Myelitis – MD Searchlight

  https://mdsearchlight.com/neurology/acute-flaccid-myelitis/

  A special type of magnetic resonance imaging (MRI) of the spinal cord with a contrast dye is usually carried out. The scan frequently shows a brightly lit area in the front part of the spinal cord, which usually spans one or more segments of the spine. […] The Centers for Disease Control and Prevention provide guidelines for the emergency treatment of Acute Flaccid Myelitis (AFM) as its a significant medical issue. […] Currently, there arent any medications approved by the Food and Drug Administration specifically to prevent or treat AFM. […] Nerve transfer surgery is a promising treatment option for those with incomplete recovery from Acute Flaccid Myelitis, where surgeons redirect healthy nerves to restore function in affected areas. […] The prognosis for Acute Flaccid Myelitis (AFM) can vary greatly. Some individuals fully recover, while others may experience severe and long-lasting nerve issues, and in some cases, it can be life-threatening.

• #61 Acute flaccid myelitis: cause, diagnosis, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7909727/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. […] The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. […] There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. […] The diagnosis of AFM can be informed by interpretation of the clinical features alongside findings of laboratory, neuroimaging, and electrophysiological tests. […] MRI of the spinal cord is the most useful diagnostic test in AFM. T2 hyperintensity of the spinal cord grey matter is the hallmark of AFM. […] CSF pleocytosis is identified in almost all patients with AFM undergoing lumbar puncture in the acute phase, with a mild to moderate elevation in white blood cell count (usually 100 per L with lymphocytic predominance), which appears to resolve over subsequent weeks.

• #62 About AFM | Acute Flaccid Myelitis Working Group

  https://acuteflaccidmyelitis.org/about-afm/

  AFM is a neurological condition characterized by a rapid onset of flaccid muscle weakness, with associated abnormalities on the radiological imaging of the spinal cord (MRI). […] A good clinical examination, an MRI of the spinal cord, and the analysis of cerebrospinal fluid are essential tests that help diagnose AFM and differentiate it from other conditions that can cause a similar presentation. […] A complete and thorough neurological exam is essential for diagnosis. Exam findings suggestive of AFM include weakness involving one or more limbs, decreased muscle tone, and decreased reflexes in the affected limbs. […] Regarding MRI findings, lesions on the grey matter of the spinal cord, usually involving several vertebral levels, are the characteristic abnormality in AFM. […] A lumbar puncture should also be completed in suspected cases. It usually reveals a moderate increase in white blood cells and mild protein elevation.

• #63 Acute Flaccid Myelitis: Diagnosis and Management Basics, Ongoing Questions | Children’s Hospital of Philadelphia

  https://www.chop.edu/news/acute-flaccid-myelitis-diagnosis-and-management-basics-ongoing-questions

  A 3-year-old male presents for the evaluation of pain and difficulty moving his right arm. […] The diagnosis of acute flaccid myelitis (AFM) is suggested by the acute onset of flaccid paralysis with proximal distal weakness and decreased deep tendon reflexes in the setting of a febrile illness, particularly an upper respiratory infection. […] A high index of suspicion is necessary to make the diagnosis of AFM, given that so many more benign conditions present with unilateral upper extremity weakness. […] Management of AFM is primarily supportive, and in the absence of controlled trials the optimal medical management remains unclear. […] The prognosis for patients with AFM is uncertain, with many patients experiencing slow and often incomplete recovery. […] In summary, AFM is an emerging condition with significant associated morbidity.

• #64 Acute Flaccid Myelitis (AFM): Causes, Symptoms, and Treatment

  https://www.medicoverhospitals.in/diseases/acute-flaccid-myelitis/

  Diagnosing AFM involves a combination of clinical evaluation, imaging studies, and laboratory tests: […] A thorough neurological examination is the first step in diagnosing AFM. Physicians look for muscle weakness, reflex abnormalities, and other neurological signs indicative of spinal cord involvement. […] Magnetic Resonance Imaging (MRI) is crucial for diagnosing AFM. MRI can reveal inflammation in the spinal cord, particularly in the gray matter, which is a hallmark of AFM. […] Laboratory tests include cerebrospinal fluid (CSF) analysis and viral testing. Elevated white blood cell count in the CSF can indicate inflammation. Viral testing helps identify potential viral triggers, although a specific virus is not always detected.

• #65 Acute Flaccid Myelitis (AFM) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/acute-flaccid-myelitis

  Acute flaccid myelitis can be difficult to diagnose because it shares symptoms with neurologic conditions like Guillain-Barré syndrome and acute transverse myelitis. To diagnose AFM, your doctor will review your child’s medical history and examine their nervous system. Your child may also need magnetic resonance imaging (MRI) to create two- and three-dimensional images of their brain and spinal cord. […] Your doctor may test the fluid around your child’s brain and spine (cerebrospinal fluid) or check the impulses in the nervous system (nerve conduction). It’s important to consult a neurologist and infectious disease doctor when diagnosing AFM. […] There is no specific treatment at this time for acute flaccid myelitis. Your child’s doctor may recommend intravenous immunoglobulin (IVIG) or other medications. Your doctor may also recommend surgery to replace the function of the damaged nerves. In nerve transfer surgery, an orthopedic surgeon transfers healthy nerves to take over the function of the nerves damaged by the virus. In tendon transfer surgery, nearby unaffected muscles are moved to take over the muscles that are weak due to the virus.

• #66 Pediatric Acute Flaccid Myelitis – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. […] Doctors typically diagnose acute flaccid myelitis by reviewing a patients medical history, examining their nervous system and performing an MRI to view pictures of the spinal cord. […] Acute flaccid myelitis can be difficult to diagnose because it shares many of the same symptoms as other neurologic diseases, such as stroke and Guillain-Barre syndrome, which also need prompt treatment. […] Currently, there is no specific treatment for acute flaccid myelitis, but doctors may recommend different treatments based on each patient. […] Research is underway to improve understanding of acute flaccid myelitis and develop better treatments.

Zobacz więcej