Materiały źródłowe

• #1 Acute Flaccid Myelitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK606127/

  Acute flaccid myelitis (AFM) is a rare but serious neurological condition that primarily affects the spinal cord, leading to sudden muscle weakness and loss of reflexes. […] The exact cause of AFM remains uncertain, though it is often associated with viral infections, particularly enteroviruses. […] The exact cause of AFM is not fully understood, but the link to certain viruses (eg, enterovirus D68, enterovirus A71, West Nile virus, adenovirus) has been observed. […] The pathophysiology of AFM involves a complex interplay of viral infections and immune responses that primarily target the spinal cord’s anterior horn cells. Enteroviruses, especially enterovirus D68, are frequently implicated, suggesting a viral etiology. The infection triggers an inflammatory response, leading to neuronal damage and subsequent muscle weakness or paralysis. […] Understanding the precise mechanisms of viral invasion and immune-mediated injury remains a focus of ongoing research, crucial for developing effective treatments and preventive measures.

• #2 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 specific mechanism by which infection with enterovirus D68 leads to AFM is not fully understood and represents a key question for future research. […] Mouse models and neuronal cell culture models suggest that recent strains of enterovirus D68 have evolved in terms of their capability of accessing the nervous system (neuroinvasion), their capacity to infect neurons (neurotropism), their ability to cause nervous system disease (neurovirulence), or any combination thereof. […] The pathogen, environmental, and host factors that can mediate progression to neurological disease are unknown. […] The potential of other alternative viral causes as major contributors to recent AFM outbreaks would appear to be diminished by clinical features, reported investigations, and epidemiological characteristics. […] The specific mechanism by which infection with enterovirus D68 leads to AFM is not fully understood and represents a key question for future research.

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

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

  Acute flaccid myelitis (AFM) is a condition that affects the nervous system, usually in young children. AFM affects the motor neurons in the spinal cord or brainstem and can progress rapidly. The most common symptoms are the sudden onset of weakness in the arms and legs. In rare cases, the loss of muscle tone and reflexes can lead to complete paralysis in one or more limbs. If you suspect your child has AFM, contact your doctor. […] Since 2014, there has been an increase in AFM cases every year. Most cases occur between August and October and coincide with the seasonal circulation of viruses, including enteroviruses. Enteroviruses, specifically D68 and A71, are possible causes of the condition. Although AFM is often described as polio-like, recent cases of AFM are not caused by the poliovirus.

• #4 About Acute Flaccid Myelitis | Acute Flaccid Myelitis (AFM) | CDC

  https://www.cdc.gov/acute-flaccid-myelitis/about/index.html

  Acute flaccid myelitis (AFM) is an uncommon but serious neurologic condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. […] AFM can be caused by viruses, including enteroviruses. AFM can also be caused by other viruses, including flaviviruses (West Nile virus, Japanese encephalitis virus), herpesviruses, and adenoviruses. […] We are working to learn why a small number of people develop AFM after having a virus. […] Currently, there is no specific treatment for AFM, but clinicians may recommend different interventions based on each patient. […] CDC is working closely with national experts to better understand how to treat AFM and will update our clinical guidance with new information when available. […] We are also working to understand the long-term outcomes of people with AFM.

• #5 Acute flaccid myelitis – Wikipedia

  https://en.wikipedia.org/wiki/Acute_flaccid_myelitis

  Acute flaccid myelitis (AFM) is a serious condition of the spinal cord. […] The cause of most cases is unclear as of 2018. More than 90% of recent cases have followed a mild viral infection such as from enteroviruses. […] The underlying mechanism involves damage to the spinal cord’s grey matter. […] Much research has focused on the nonpolio enteroviruses 68 (EV-D68) and 71 (EV-A71), a common cause of hand, foot, and mouth disease in infants and young children, members of the enterovirus D and enterovirus A species, respectively, as suspected causes. […] Some evidence supports a causal role of EV-D68. […] Diagnosis of AFM requires acute onset limb paralysis and at least one gray-matter spinal-cord lesion. CSF should show pleocytosis.

• #6 Acute Flaccid Myelitis (AFM)

  https://www.health.ny.gov/diseases/conditions/acute_flaccid_myelitis/

  Acute Flaccid Myelitis is a rare but serious condition that affects the nervous system. It was first discovered in 2014. Acute Flaccid Myelitis mostly occurs in young children and targets the gray matter in the spinal cord, making muscles and reflexes in one or more limbs weak. This weakness happens quickly, often affects one side of the body more than the other and can lead to paralysis. […] The exact cause of Acute Flaccid Myelitis is still unknown. Most patients had mild respiratory or gastrointestinal (stomach) symptoms, or a fever, 1-2 weeks before their limb weakness started. This may suggest a viral infection. Non-polio enteroviruses, such as enterovirus D-68, are thought to be linked to Acute Flaccid Myelitis.

• #7

  https://link.springer.com/article/10.1007/s00431-019-03435-3

  Acute flaccid myelitis is characterized by the combination of acute flaccid paralysis and a spinal cord lesion largely restricted to the gray matter on magnetic resonance imaging. […] We also discuss the association with enterovirus D68 and the presumed pathophysiological mechanism of this infection causing anterior horn cell damage. […] A causal relationship between EV-D68 and AFM is supported by epidemiological and biological evidence, as was evaluated by different groups applying the Bradford Hill criteria. […] The biological evidence mainly came from mouse models, in which mice infected with contemporary circulating strains of EV-D68 develop flaccid paralysis mimicking AFM. […] Pathologic examination of infected mice revealed the presence of the virus in the anterior horn with associated cell loss.

• #8 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 can be caused by some viruses, environmental toxins, and genetic disorders. […] Viruses that can cause AFM include enteroviruses (polio and non-polio) and flaviviruses such as West Nile Virus, Japanese Encephalitis virus, or St. Louis encephalitis virus. […] Even with testing, sometimes the cause of AFM is never found. […] AFM is often hard to diagnose. […] There is no specific treatment for AFM. […] Pathogen-specific testing should be performed locally at hospital or state public health laboratories.

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

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

  There is no single cause of acute flaccid myelitis. Most patients with AFM had a respiratory illness or fever that might have been caused by a viral infection before they were diagnosed with AFM. Enteroviruses are common viral infections in children and, in rare cases, can also cause neurologic illness. […] It is not currently known why some patients with viral infections develop AFM while others recover. AFM is often compared to polio, which is a viral infection of the motor neurons. However, no recent U.S. cases have been linked to the poliovirus.

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

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

  Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. […] It’s not clear why some people with an enterovirus infection develop acute flaccid myelitis. […] 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.

• #11 Acute Flaccid Myelitis | PM&R KnowledgeNow

  https://now.aapmr.org/acute-flaccid-myelitis/

  While exact cause and pathology has yet to be identified, pathogenesis is likely initially infectious and immune-mediated. […] A possible viral cause is enterovirus which is a respiratory virus closely related to rhinovirus infrequently occurring in US until late 2000s. […] A majority of insults appear to be in spinal column. There is a predilection for involvement of the anterior horn cells. […] Three general phases of pathogenic process have been proposed: Inflammatory: largely reversible, Demyelination: moderately reversible, Axon transection: marginally reversible. […] Two pathophysiological subtypes have been identified on imaging: gray-matter restricted and mixed gray-white matter. […] It has been proposed that the initial inflammation that occurs in the anterior horn cells may spill into adjacent white matter. This may explain presentation of mixed upper motor neuron and lower motor neuron signs. […] Some patients may present with MRI brain abnormalities in the dorsal pons, medulla, cerebellum, or varied supratentorial lesions.

• #12 Study Confirms Pathogenesis of EV-D68 Virus Causing Polio-like Paralyzing Illness in Children | Newsroom

  https://news.unchealthcare.org/2022/05/study-confirms-pathogenesis-of-ev-d68-virus-causing-polio-like-paralyzing-illness-in-children/

  Twelve years after a five-year-old boy died from acute flaccid myelitis (AFM), researchers continued to investigate the pathology and immune response of this polio-like illness. A new case report in the New England Journal of Medicine provides evidence that Enterovirus D68 RNA and protein were found in the spinal cord of preserved autopsy tissue proof that EV-D68 causes AFM. […] A case report published in the New England Journal of Medicine provides evidence that enterovirus D68 directly infects spinal cord neurons and that a corresponding robust immune response is present a direct causation to the polio-like paralyzing illness, acute flaccid myelitis (AFM). […] Increasing evidence has grown to show a causal link between enterovirus D68 (EV-D68) infection, one of more than 100 non-polio enteroviruses, and AFM.

• #13 Study Confirms Pathogenesis of EV-D68 Virus Causing Polio-like Paralyzing Illness in Children | Newsroom

  https://news.unchealthcare.org/2022/05/study-confirms-pathogenesis-of-ev-d68-virus-causing-polio-like-paralyzing-illness-in-children/

  Over time scientists have done quite a bit of experimentation in the lab and found a lot of evidence showing its likely that EV-D68 is a major cause of AFM, said Vogt. Investigators have been able to use mouse models to document severe symptoms and observe the virus infecting motor neurons in the spinal cord. Those are the exact neurons that control movement in the limbs that are now paralyzed. […] The pathogenesis was confirmed when the study revealed EV-D68 directly infecting spinal cord neurons. The region of infected neurons clinically corresponded to upper limb weakness and a robust immune response was also present. […] These findings further lend plausibility to the role of immunopathogenesis contributing to AFM. A final piece that connects EV-D68 causation for acute flaccid myelitis.

• #14 :: 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. […] The exact causes of AFM are still unclear. […] This review provides a concise report of our current understanding of the mechanism underlying AFM pathogenesis, its etiological factors, differential diagnosis, potential treatments, and available therapy options. […] Due to limitations of the research in this field, the exact pathogenetic mechanism underlying AFM is unclear, but it is thought to be associated with EV-D68 infections in children. […] How EV-D68 travels to infect the anterior horn cells of the spinal cord or motor neurons is currently unknown, but this probably occurs via the peripheral circulation or neural routes. […] Despite a possible association of EV with AFM due to the co-occurrence of increased AFM incidence and EV-D68 circulation in the same years, the virus has not been consistently detected in the biofluids of AFM patients. […] The lack of studies involving animal models (in vivo or ex vivo) and cell cultures (in vitro) greatly limits our thorough understanding of AFM pathogenesis.

• #15

  https://link.springer.com/article/10.1007/s00431-019-03435-3

  EV-D68 probably reaches the anterior horn by retrograde axonal transport, as is supported by both mouse studies and in vitro studies in human motor neurons. […] Although the results from mouse studies cannot simply be extrapolated to humans, these results are suggestive of a damaging effect of the virus in anterior horn cells, possibly combined with a direct damaging effect on muscles through viral myositis. […] Important questions remain why only some EV-D68 infected patients develop AFM and how the variability in severity of AFM in affected patients is explained.

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

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

  AFM is a rare but serious condition that affects the spinal cord and can cause paralysis, primarily in children. […] With acute flaccid myelitis, motor neurons within the gray matter of the spinal cord become damaged, causing muscle weakness and potentially paralysis of one or more limbs. […] The exact causes of AFM aren’t fully known, but research has shown that enterovirus D68, a respiratory virus, is the most likely cause for the alternating-year outbreaks. […] Current models suggest that the virus can spread from the lungs to a person’s spinal cord, infecting the lower motor neurons and causing death. This process might also draw out an immune response that can cause damage to the spinal cord. […] AFM is often described as a polio-like illness, but in the U.S., AFM cases since 2014 have not been caused by poliovirus, a type of enterovirus. All the stool specimens from AFM patients that the CDC has received have tested negative for poliovirus.

• #17 Acute Flaccid Myelitis — LittleArms.org

  https://www.littlearms.org/acute-flaccid-myelitis

  Based on animal studies, it is believed that AFM is caused by a viral infection from the same family of viruses as the polio virus (enteroviruses). The virus gets into the blood stream of a child, and targets the muscles for infection. Once inside the muscle, the virus replicates (uses the machinery of the muscle cell to makes copies of itself) and often kills parts of the muscle in the process. In some children, the virus crosses the neuromuscular junction (the place where a nerve meets a muscle) and travels up the motor nerve axons via retrograde axoplasmic flow to the cell body within the anterior horn of the spinal cord. Once inside the spinal cord, it can infect other motor nerve cells. Afferent and autonomic nerve cells are spared by the virus, but may be injured by the body as the immune system fights the virus. We do not know why the virus only targets motor nerves and spares other nerve types.

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

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

  AFM causes inflammation in the gray matter of your spinal cord. […] Researchers don’t know the exact cause of acute flaccid myelitis, but they think that viruses, especially non-polio enteroviruses, play a role in causing the condition. […] Researchers and healthcare providers have suspected enterovirus D68 and enterovirus A71 in many AFM cases. Enterovirus D68 most often causes a respiratory illness and circulates in the United States during the summer and fall every other year. […] AFM can also cause serious neurologic complications, such as body temperature changes, blood pressure instability and irregular heart rate, which can be life-threatening.

• #19 Acute flaccid myelitis – UpToDate

  https://www.uptodate.com/contents/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is an acquired spinal cord disorder that presents with the rapid onset of weakness in one or more limbs. […] The clinical syndrome of acute motor neuron weakness (acute flaccid paralysis [AFP] or AFM) is caused by dysfunction or death of anterior horn cells within the gray matter of the spinal cord. Damage to these lower motor neurons leads to flaccid weakness of the innervated limb.

• #20 Acute Flaccid Myelitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/161699

  The exact cause of AFM remains elusive. AFM has been associated with various viral infections, particularly non-polio enteroviruses D68 and A71. Other viruses like adenovirus and West Nile virus have also been implicated. Evidence supporting the causative role of enterovirus D68 in AFM in animal models includes loss of spinal cord motor neurons in affected limbs, virus detection in motor neurons of the spinal cord, and development of paralysis by injecting the virus-containing serum from affected mice into healthy ones, fulfilling Koch postulates, and preventing AFM by administering serum with enterovirus D68 antibodies from previously infected mice. Further research is needed to address limitations and strengthen the evidence base. […] The pathophysiology of AFM involves a complex interplay of viral infections and immune responses that primarily target the spinal cord’s anterior horn cells. Enteroviruses, especially enterovirus D68, are frequently implicated, suggesting a viral etiology. The infection triggers an inflammatory response, leading to neuronal damage and subsequent muscle weakness or paralysis. The destruction of motor neurons disrupts the transmission of nerve signals to muscles, resulting in the characteristic flaccid paralysis. This damage can be extensive and irreversible, leading to varying degrees of long-term disability. Understanding the precise mechanisms of viral invasion and immune-mediated injury remains a focus of ongoing research, crucial for developing effective treatments and preventive measures.

• #21 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). […] We are still learning about what causes this unusual illness, and how is it causing the paralysis. There is evidence that supports a connection between the recent outbreaks of AFM with non-polio enterovirus infections as potential causative agents. […] Although this reinforces the idea of a virus as a driving agent of the disease, the mechanism by which the virus might cause injury to the spinal cord is not well understood. Direct neuronal infection and indirect immunological response have been proposed as potential explanations.

• #22 Study Confirms Pathogenesis of EV-D68 Virus Causing Polio-like Paralyzing Illness in Children | Newsroom

  https://news.unchealthcare.org/2022/05/study-confirms-pathogenesis-of-ev-d68-virus-causing-polio-like-paralyzing-illness-in-children/

  The challenge is if you take away the entire immune response then you might take the brakes off that virus infection, causing the virus to go out of control. […] The data have shown when the antibody is given to infected mice during the onset of paralysis, this treatment does help improve outcomes meaning that it will improve overall paralysis. Since this piece of evidence in the study leaves no doubt that EV-D68 causes AFM, information derived from this case report may inform treatment approaches and further direction of laboratory studies.

• #23 Acute Flaccid Myelitis (AFM) | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/afm/

  Acute flaccid myelitis (AFM) is a sudden onset of paralysis in the spinal cord. […] In acute flaccid myelitis, myelin is attacked and destroyed for some unknown reason. […] AFM affects LMNs, with the result of flaccid (limp) muscle weakness, muscular atrophy (wasting), fasciculation (single nerve twitches), and hyporeflexia (poorly responding reflexes). […] It has been thought that AFM is a variation of diseases such as Transverse Myelitis (TM) or Guillain Barr Syndrome (GBS). Internal body inflammation could be the source of damage to myelin. […] The causes and treatments for AFM are actively being researched. […] Many studies are being conducted to find out more about the etiology (origin) of the condition.

• #24 Acute Flaccid Myelitis (AFM) | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/afm

  Acute flaccid myelitis (AFM) is characterized by rapid onset of flaccid weakness in one or more limbs without a known cause and distinct abnormalities of the spinal cord gray matter on magnetic resonance imaging (MRI). […] There is no single known cause of AFM; all infectious and non-infectious etiologies are investigated. It has been primarily associated with viruses such as non-polio enteroviruses which typically cause mild illness such as a fever or respiratory infections. […] More research needs to be done to better understand why some people develop AFM after a viral infection and why others do not.

• #25 Acute Flaccid Myelitis Los Angeles | Polio Symptoms Los Angeles

  https://www.losangelesnerve.com/conditions/arms/acute-flaccid-myelitis-afm/

  AFM can be caused by a common cold virus (Enterovirus, Adenovirus). The virus turns off one or more major nerves directly at their source in the spinal cord. This location of the injury is identical to the area of the spinal cord affected in Lou Gehrigs disease (ALS). […] Presently, doctors and researchers have not been able to identify any specific environmental or patient-specific risk factors placing someone at higher risk for developing AFM after a common cold.

• #26 Causes, diagnosis and management of acute flaccid myelitis – Children’s National

  https://innovationdistrict.childrensnational.org/causes-diagnosis-and-management-of-acute-flaccid-myelitis/

  Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. […] 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.

• #27 Acute Flaccid Myelitis (AFM) | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/acute-flaccid-myelitis-afm/

  Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system. […] The cause of the illness is unknown but the Centers for Disease Control and Prevention (CDC) cites possible causes of AFM include viruses, environmental toxins and genetic diseases. […] According to the CDC, AFM can be difficult to diagnose since it shares many similar symptoms to other neurological diseases. […] Treatment for AFM is on a case-by-case basis. Most often, physical and occupational therapy are required to help with limb weakness or paralysis caused by AFM.

• #28 Acute Flaccid Myelitis – Child Neurology Foundation

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

  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. […] Intravenous immunoglobulin (IVIG) may be used to help the body build an immune response to fight the infection. Steroids and plasma exchange are sometimes used. […] Most children will have lasting disabilities. They may regain some function in the affected limbs. Symptoms related to injury to the brainstem are more likely to resolve than limb weakness. Nerve transfer surgery may benefit some children. Physical therapy, occupational therapy, and speech therapy are critical.

• #29 Acute Flaccid Myelitis — Pediatric EM Morsels

  https://pedemmorsels.com/acute-flaccid-myelitis/

  In 2014, the term Acute Flaccid Myelitis was coined and aimed to help characterize presentations that were similar to Polio, but without poliovirus being found. […] Extensive testing did not reveal clear etiology, but Concurrent outbreak of Enterovirus EV-D68 was noted to be associated. […] The Center for Disease Control defines Acute Flaccid Myelitis (AFM) as: Acute Flaccid Limb Weakness with Spinal Cord Lesions in the Gray Matter on MRI. […] It starts like so many other stories with a Viral Prodrome! […] Weakness develops rapidly. […] AFM may have: Progression stops over days, Asymmetric weakness, No sensory symptoms, CSF pleocytosis, Spinal Cord and Brain Stem Lesions on MRI. […] MRI is the imaging modality of choice. […] An Acute Flaccid Myelitis Protocol has been suggested and includes various labs that may prove to help eliminate other diagnoses.

• #30 Department of Public Health – Acute Communicable Disease Control

  http://publichealth.lacounty.gov/acd/Diseases/AFM.htm

  Acute flaccid myelitis (AFM) is an illness characterized by a sudden onset of acute flaccid limb weakness without a known cause and magnetic resonance imaging (MRI) showing lesions in the gray matter of the spinal cord. Most cases are in children. […] The agent is unknown, but most likely viral. The specific causes(s) are still under investigation and may include: Non-polio enteroviruses (Enteroviruses D68, Enteroviruses A71, Coxackievirus A16). Flaviviruses (West Nile Virus, Japanese Encephalitis Virus). Herpesvirus. […] Clinical diagnosis is made by reviewing neurological symptoms, examining brain and spinal MRIs, Cerebrospinal Fluid (CSF) testing and testing of nerve conduction and response.

• #31 Acute flaccid myelitis (AFM)

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20491145

  Acute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. […] It’s not clear why some people with an enterovirus infection develop acute flaccid myelitis. […] 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. […] Currently, there is no specific treatment for acute flaccid myelitis. Treatment is aimed at managing symptoms. […] However, it’s not clear whether these treatments have any benefits.

• #32 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. […] Acute flaccid myelitis (AFM) is a rare but serious nerve-related condition that occurs mostly in children it is similar to polio. It comes from a virus that is the common cold. This polio-like illness attacks the spinal cord and the nerves that go to the muscles. […] While the reason certain children develop AFM is still unclear, it typically occurs following a viral infection that causes the common cold (Enterovirus D68, Coxsackie Virus and others). However, it is still unknown how or why these infections trigger AFM symptoms in some patients. […] There is no established medical treatment or medications to cure AFM. At first, patients are treated with supportive care including hospital admission, medications such as steroids and treatments that include plasmapheresis and/or IVIG.

• #33 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. […] AFM is thought to be caused by infections with different types of viruses. The infections most commonly mentioned with AFM include polio or West Nile virus and related infections, though these are not always the cause. […] Other causes of AFM are still being explored and might include environmental toxins and genetic disorders. […] 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. […] Some children who have AFM undergo nerve transplants to regain lost mobility within 6-12 months after diagnosis. […] Gillette offers comprehensive treatment for the symptoms of AFM, from rehabilitative therapy to nerve transplant surgery.

• #34 Acute Flaccid Myelitis: MedlinePlus

  https://medlineplus.gov/acuteflaccidmyelitis.html

  AFM can be caused by several different viruses. Researchers think that enteroviruses have been causing the recent increases in the number of children with AFM. AFM can also be caused by other viruses, including flaviviruses, herpesviruses, and adenoviruses. […] There is no specific treatment for AFM. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend treatments for specific symptoms. For example, physical and/or occupational therapy may help with arm or leg weakness. Researchers do not know the long-term outcomes of people who get AFM.

• #35

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

  Ninety-nine articles were included in this review. The precise cause and pathophysiologic mechanism of AFM remain undetermined, but AFM is strongly associated with nonpolio enterovirus infections. […] Supportive care includes medical therapy and rehabilitation. Early studies of nerve transfer for AFM have shown favorable outcomes for patients with persistent weakness. […] For patients with persistent limb weakness, nerve transfer has shown promise for improving function in distal muscle groups.

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

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

  If muscle movement does not come back a surgical procedure can be performed to help. These are called nerve transfers. A nerve transfer involves finding a healthy working nerve and connecting it to a non-working muscle. In time, the working nerve grows into the muscle and over time (9-12 months) movement can happen. This helps to rewire the nerves to give children better movement and strength in their limbs. […] Dr. Moore was the first to describe nerve transfer interventions for AFM patients with lower extremity involvement and has evaluated and treated over 50 patients with AFM since 2017. Together with Dr. Bjorklund, the surgical team has the experience and expertise to improve lives in patients with AFM.

• #37 Acute Flaccid Myelitis — Paralysis Center

  https://www.paralysiscenter.org/acute-flaccid-myelitis

  Acute flaccid myelitis (AFM) is a rare condition that primarily affects children and results in paralysis of a portion or the entirety of a single limb, arm or leg. […] This condition occurs as a complication of a viral infection in which the virus attacks the spinal cord and destroys the gray matter (the part that is the source of the nerves that provide movement to the limb). […] AFM is a polio-like condition that appears to be related to a viral infection. […] The mainstay of treatment for this condition is surgery. […] Because there is no source nerve, nerve transfers are the primary treatment. […] Because this is a lower motor neuron injury, time is of the essence. Surgery undertaken by three months is more effective that that undertaken after nine months. […] Similar to brachial plexus injuries, there are still options if you have missed this window of opportunity. Tendon transfers and muscle transplants can still provide an opportunity to recovery lost function and a better quality of life.

• #38 Understanding the pathogenesis of enterovirus D68 associated acute flaccid myelitis (AFM) through treatments & cloning – CU Anschutz Digital Collections

  https://digitalcollections.cuanschutz.edu/work/ns/fdde6e70-815f-4417-8583-c0ac2fc9c8c4

  Enterovirus D68 (EV-D68) is a picornavirus isolated in the 1960s that was rarely detected in respiratory samples during the 20th century. However, over the last twenty years, EV-D68 has established a global foothold, with significant outbreaks as recent as 2022. […] Research included in this thesis worked to elucidate the genomic changes in EV-D68 driving this novel neurotropism. Through comparison of 2014 isolates, IL/14-18952 and CA/14-4231, the novel neurovirulent phenotype of EV-D68 was found to be primarily the result of changes within the capsid proteins VP3 and VP1, with the 5UTR influencing paralytic outcomes to a lesser extent. […] As such, there is an urgent need for EV-D68 antivirals and other effective interventions. This thesis outlines treatment discovery efforts, including the successful discovery of the first EV-D68 antiviral, telaprevir, shown to be efficacious at limiting paralysis in an immunocompetent mouse model.

• #39 Understanding the pathogenesis of enterovirus D68 associated acute flaccid myelitis (AFM) through treatments & cloning – CU Anschutz Digital Collections

  https://digitalcollections.cuanschutz.edu/work/ns/fdde6e70-815f-4417-8583-c0ac2fc9c8c4

  Even more promising is the use of immunotherapies to treat EV-D68. This thesis demonstrates successful use of a monoclonal humanized antibody, 15C5-Chmra, that effectively halts paralysis progression, even when given after neurological symptom onset. […] The work presented in this thesis advances our understanding of the molecular determinants of EV-D68 neurological disease and highlights promising treatment routes to pursue for EV-D68 associated AFM.

• #40 Acute flaccid myelitis | Great Ormond Street Hospital

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

  Plasma exchange, or plasmapheresis, is a procedure that washes the blood, removing plasma, the part of the blood which contains antibodies, from the blood cells and replaces the plasma with a different fluid (usually albumin). […] As acute flaccid myelitis (AFM) is a newly discovered disease, there isnt much data about the long term effects and outlook for those affected. […] From the cases that have been studied to date, AFM is life-threatening for a small number of children, particularly those whose breathing is affected.

• #41 Acute flaccid myelitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/acute-flaccid-myelitis

  Acute flaccid myelitis is a rare condition that affects the nervous system. Inflammation of the gray matter in the spinal cord leads to muscle weakness and paralysis. […] Acute flaccid myelitis (AFM) is usually caused by infection with a virus. […] Different kinds of viruses may be the cause of AFM. These include: Enteroviruses (poliovirus and non-poliovirus), West Nile virus and similar viruses such as Japanese encephalitis virus and Saint Louis encephalitis virus, Adenoviruses. […] It is unclear why certain viruses trigger AFM, or why some people develop the condition and others don’t. […] Environmental toxins also can cause AFM. In many cases, a cause is never found. […] There is no specific treatment for AFM. […] A number of medicines and treatments that work on the immune system have been tried but have not been found to help. […] The long-term outlook of AFM is not known. […] Complications of AFM include: Muscle weakness and paralysis, Loss of limb function. […] There is no known way to prevent AFM. Having a polio vaccine may help reduce the risk of AFM related to the poliovirus.

• #42 ACUTE FLACCID MYELITIS (AFM)

  https://oeps.wv.gov/afm/pages/default.aspx

  Acute Flaccid Myelitis is a syndrome characterized by sudden onset of weakness in one or more limbs and distinct abnormalities of the spinal cord gray matter on magnetic resonance imaging (MRI). […] The cause of this illness remains unknown. Conditions like acute flaccid myelitis can be caused by a variety of germs including several viruses such as: enteroviruses (polio and non-polio), West Nile virus, Japanese encephalitis, Saint Louis encephalitis virus, herpesviruses, and adenoviruses. […] However, despite extensive laboratory testing, the cause for AFM is difficult to identify. […] Currently the mode of transmission is unknown. This would depend on the agent causing AFM. Transmission could be through respiratory secretions such as with adenovirus or through the fecal/oral route such as with poliomyelitis or other enteroviruses. […] The illness typically manifest as sudden onset of asymmetrical limb weakness, loss of muscle tone and reflexes. Additional signs and symptoms may vary, although the most severe symptom is respiratory failure. Recovery from AFM can be prolonged.

• #43 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. […] Certain viruses have been associated with the development of this serious condition. Viruses, such as enteroviruses A71, West Nile virus and poliovirus, have been found to be potentially implicated in the pathogenesis of AFM. […] The exact mechanism responsible for initiating the trigger is still unknown. […] Current treatment strategies usually involve physical and occupational therapies to manage the limb weakness. There is urgent need to establish the long-term effects of this rare disease, and research is directed towards this need, as well as to better understanding of the condition and its pathogenesis.

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