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Acute Flaccid Myelitis: Symptoms, Causes, Diagnosis And Treatment

Acute flaccid myelitis or AFM, a rare disease that affects the spinal cord, the part of the nervous system that carries messages to and from the brain is a polio-like illness. The rare but serious condition affects a child's nervous system and causes the muscles to be weak and floppy.

The condition causes the child to become paralysed and is one of the rarest and dangerous diseases. Although there has been uncertainty regarding the exact cause of the condition, a recent study asserted that the condition could be possibly caused by a strain of a respiratory virus called enterovirus [1] .

Acute flaccid myelitis usually develops after a respiratory infection, such as a cold and causes drooping eyelids, trouble moving the eyes, drooping mouth, slurred speech, trouble swallowing and trouble breathing [2] .

Symptoms Of Acute Flaccid Myelitis

As aforementioned, the condition causes the child the following signs[3] :

  • Weakness in arms and legs
  • Slurred speech
  • Drooping eyelids and trouble moving your eyes
  • Trouble breathing
  • A hard time swallowing or speaking

Causes Of Acute Flaccid Myelitis

Till date, there has been wide-spread confusion as to what exactly causes acute flaccid myelitis. However, according to a recent study, the cause is asserted to be a strain of a respiratory virus called enterovirus [1] .

Rare Polio-like Disease In Children May Be Caused By A Respiratory Virus

Various studies had attempted to find the missing virus in the spinal fluid but the traditional testing methods did not help find the cause. The researchers, in the current study, made use of an enhanced version of the virus-hunting tool called VirScan which aided in finding the presence of antibodies against the enterovirus [4] .

Diagnosis Of Acute Flaccid Myelitis

The condition is rather difficult to diagnose as the symptoms can indicate the prevalence of other diseases related to your brain and nervous systems, such as transverse myelitis and Guillain-Barre syndrome [5] .

Some of the measures involved in the diagnosis of AFM are as follows [6] :

  • Carry out an MRI scan to examine your brain and spinal cord
  • A spinal tap or lumbar puncture to test the fluid around your brain
  • Check your muscle tone and reflexes with a physical exam
  • Check your nerve responses to electrical impulses

Treatment For Acute Flaccid Myelitis

As there is no cure for the condition, the medical care aims at improving and managing the symptoms [7] . Children with acute flaccid myelitis are prescribed the following:

  • Physical therapy to make weak muscles stronger
  • Occupational therapy to help with everyday activities like dressing and eating
  • Pain relievers like ibuprofen to ease pain and bring down the fever
  • Fluids to keep them from being dehydrated

Some children will require a ventilator to help them breathe [8] .

Consequently, with no vaccine or cure for the condition - the recent study has opened up a vast scope for further research, with the head researchers assimilating that the next practical step would be to include research into antiviral drugs and also develop a vaccine for AFM.

View Article References
  1. [1] Greninger, A. L., Naccache, S. N., Messacar, K., Clayton, A., Yu, G., Somasekar, S., ... & Messenger, S. (2015). A novel outbreak enterovirus D68 strain associated with acute flaccid myelitis cases in the USA (2012–14): a retrospective cohort study. The Lancet Infectious Diseases, 15(6), 671-682.
  2. [2] Sejvar, J. J., Lopez, A. S., Cortese, M. M., Leshem, E., Pastula, D. M., Miller, L., ... & Fischer, M. (2016). Acute flaccid myelitis in the United States, August–December 2014: results of nationwide surveillance. Clinical Infectious Diseases, 63(6), 737-745.
  3. [3] Messacar, K., Schreiner, T. L., Van Haren, K., Yang, M., Glaser, C. A., Tyler, K. L., & Dominguez, S. R. (2016). Acute flaccid myelitis: a clinical review of US cases 2012–2015. Annals of neurology, 80(3), 326-338.
  4. [4] Pfeiffer, H. C., Bragstad, K., Skram, M. K., Dahl, H. M., Knudsen, P. K., Chawla, M. S., ... & Rojahn, A. (2015). Two cases of acute severe flaccid myelitis associated with enterovirus D68 infection in children, Norway, autumn 2014.
  5. [5] Messacar, K., Asturias, E. J., Hixon, A. M., Van Leer-Buter, C., Niesters, H. G., Tyler, K. L., ... & Dominguez, S. R. (2018). Enterovirus D68 and acute flaccid myelitis—evaluating the evidence for causality. The Lancet Infectious Diseases, 18(8), e239-e247.
  6. [6] Van Haren, K., Ayscue, P., Waubant, E., Clayton, A., Sheriff, H., Yagi, S., ... & Wadford, D. A. (2015). Acute flaccid myelitis of unknown etiology in California, 2012-2015. Jama, 314(24), 2663-2671.
  7. [7] Aliabadi, N., Messacar, K., Pastula, D. M., Robinson, C. C., Leshem, E., Sejvar, J. J., ... & Dominguez, S. R. (2016). Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerging infectious diseases, 22(8), 1387.
  8. [8] Nelson, G. R., Bonkowsky, J. L., Doll, E., Green, M., Hedlund, G. L., Moore, K. R., & Bale Jr, J. F. (2016). Recognition and management of acute flaccid myelitis in children. Pediatric neurology, 55, 17-21.
Read more about: afm acute flaccid myelitis
Story first published: Tuesday, November 5, 2019, 9:00 [IST]
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