Abstract
Acute flaccid myelitis (AFM) is a polio-like syndrome characterized by acute inflammatory anterior horn cell disease. A widespread incidence of such cases in the United States in 2014 led to the coining of this new term. The features of AFM include a rapid onset of asymmetric extremity weakness with a proximal predominance that nadirs in 2–3 days, decreased or flaccid tone, and absent deep tendon reflexes in the affected extremities. Bulbar symptoms may occur, while mental status, sensation, and bladder and bowel function are typically preserved. A viral prodrome is typically associated. Prompt evaluation is critical for differentiating acute flaccid myelitis from other treatable causes of acute flaccid paralysis as proven treatments exist for other disorders. Supportive and neuro-rehabilitative therapy is central to the management of AFM; various immune-modulating treatments have been tried but have not shown to be effective. Long-term outcomes vary widely. A specific pathogen has not been identified in recent cases of AFM although several pathogens are known to cause a similar pattern of injury.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Ayscue P, Van Haren K, Sheriff H, et al. Acute flaccid paralysis with anterior myelitis—California, June 2012–June 2014. MMWR Morb Mortal Wkly Rep. 2014;63(40):903–6.
Sellner J, Luthi N, Schupbach WM, et al. Diagnostic workup of patients with acute transverse myelitis: spectrum of clinical presentation, neuroimaging, and laboratory findings. Spinal Cord. 2008;47:312–7.
Fokke C, Van Den Berg B, Drenthen J, et al. Diagnosis of Guillain-Barré syndrome and validation of brighton criteria. Brain. 2014;137(1):33–43.
Cohen HA, Ashkenasi A, Ring H, et al. Poliomyelitis-like syndrome following asthma attack (Hopkins’ syndrome)—recovery associated with IV gamma globulin treatment. Infection. 1998;4:247–9.
Pyrgos V, Younus F. High-dose steroids in the management of acute flaccid paralysis due to West Nile virus infection. Scan J Infect Dis. 2004;36(6–7):509–12.
Acute flaccid myelitis: interim considerations for clinical management. Centers for Disease Control and Prevention Website. http://www.cdc.gov/ncird/investigation/viral/sep2014/hcp.html. Published November 7, 2014. Last Updated November 28, 2014. Accessed 5 Dec 2014.
Chang LY, Huang LM, Shur-Fen Gau S, et al. Neurodevelopment and cognition in children after enterovirus-71 infection. N Engl J Med. 2007;356:1226–34.
Poliomyelitis. World Health Organization Website. http://www.who.int/ith/vaccines/polio/en/. Accessed 4 Mar 2015.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Morris, S., Kim, YM., Waubant, E., Van Haren, K., Mar, S.S. (2017). Acute Flaccid Myelitis. In: Waubant, E., Lotze, T. (eds) Pediatric Demyelinating Diseases of the Central Nervous System and Their Mimics. Springer, Cham. https://doi.org/10.1007/978-3-319-61407-6_31
Download citation
DOI: https://doi.org/10.1007/978-3-319-61407-6_31
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-61405-2
Online ISBN: 978-3-319-61407-6
eBook Packages: MedicineMedicine (R0)