Presentation
Clinicians should be alert to patients presenting with sudden onset of arm or leg weakness accompanied by loss of muscle tone and decreased reflexes. [medscape.com]
Patients also may present with a droopy face or difficulty swallowing or speaking. [aappublications.org]
He also suggested that adults with respiratory diseases should also be evaluated for neurologic deficits, and that infectious disease should be considered as a cause when patients presented with neurologic symptoms. [15] A subsequent report described [en.wikipedia.org]
Entire Body System
-
Weakness
Most people will have sudden onset of: Arm or leg weakness Loss of muscle tone and reflexes Sudden arm or leg weakness Some people will also have: Facial droop or weakness Difficulty moving eyes Drooping eyelids Difficulty swallowing Slurred speech Pain [cdc.gov]
In addition, four patients experienced neck pain or headache, and two experienced diarrhea before weakness onset. Four patients had marked weakness of proximal muscle groups in one arm, although distal motor function was largely preserved. [medscape.com]
This weakness may progress to weakness of the muscles that control breathing, so seeking care for a child who is developing weakness is important. AFM is rare, but an increasingly recognized cause of paralysis, occurring primarily in children. [chop.edu]
Most people with AFM will suddenly have Arm or leg weakness A loss of muscle tone and reflexes Some people also have other symptoms, including Facial drooping/weakness Trouble moving the eyes Drooping eyelids Trouble swallowing Slurred speech Sometimes [medlineplus.gov]
-
Pain
CHOP’s pediatric neurologists partner with other specialties across the hospital, such as physical therapy, occupational therapy, orthopaedics, pulmonary, pain management, and neuropsychiatry to coordinate your child’s care as necessary. [chop.edu]
Most people will have sudden onset of: Arm or leg weakness Loss of muscle tone and reflexes Sudden arm or leg weakness Some people will also have: Facial droop or weakness Difficulty moving eyes Drooping eyelids Difficulty swallowing Slurred speech Pain [cdc.gov]
Some people with AFM report pain. [1] [2] In some cases, AFM can affect the nerves controlling the head and neck, causing facial weakness, drooping of the eyelids, and difficulty swallowing, speaking, or moving the eyes. [1] The most serious complication [rarediseases.info.nih.gov]
Her vigorous, active toddler was recovering from a cold when he suddenly began to have trouble walking, crying as though in pain. His face "looks funny," the parent reports. Could this be your first patient with acute flaccid myelitis (AFM)? Figure. [medscape.com]
-
Weight Loss
"Bethel Pharmacy – Tulsa's Hormone, Weight Loss, & Health Experts". Rice AD, Patterson K, Wakefield LB, Reed ED, Breder KP, Wurn BF, King CR, Wurn LJ (March 2015). [en.wikipedia.org]
-
Crying
Her vigorous, active toddler was recovering from a cold when he suddenly began to have trouble walking, crying as though in pain. His face "looks funny," the parent reports. Could this be your first patient with acute flaccid myelitis (AFM)? Figure. [medscape.com]
Respiratoric
-
Sneezing
[…] viral infections by Washing hands often with soap and water Avoiding touching your face with unwashed hands Avoiding close contact with people who are sick Cleaning and disinfecting surfaces that you frequently touch, including toys Covering coughs and sneezes [medlineplus.gov]
Avoid touching face with unwashed hands Avoid close contact with people who are sick You can decrease the risk of spreading viral infections by: Cleaning and disinfecting frequently touched surfaces, including toys and doorknobs Covering coughs and sneezes [cdc.gov]
Gastrointestinal
-
Dysphagia
Is this dysphagia or odynophagia or both? Technically it is dysphagia, but individuals may describe it as painful swallowing (odynophagia). [emedicinehealth.com]
-
Dysphagia
Is this dysphagia or odynophagia or both? Technically it is dysphagia, but individuals may describe it as painful swallowing (odynophagia). [emedicinehealth.com]
Urogenital
-
Urinary Retention
retention [3] Usual onset Rapid [3] Causes Generally unknown [4] Diagnostic method Medical imaging, nerve conduction studies, cerebral spinal fluid testing [3] [5] Differential diagnosis Transverse myelitis, Guillain–Barré syndrome, acute disseminated [en.wikipedia.org]
Neurologic
-
Limb Weakness
AFM is a rare but serious cause of sudden onset limb weakness, especially in children, and should be considered in the differential diagnosis. [medscape.com]
Upper limb involvement only was more prevalent in confirmed cases (42%), as was report of respiratory symptoms or fever (92%) within four weeks preceding limb weakness onset. [en.wikipedia.org]
-
Slurred Speech
Most people will have sudden onset of: Arm or leg weakness Loss of muscle tone and reflexes Sudden arm or leg weakness Some people will also have: Facial droop or weakness Difficulty moving eyes Drooping eyelids Difficulty swallowing Slurred speech Pain [cdc.gov]
Most people with AFM will suddenly have Arm or leg weakness A loss of muscle tone and reflexes Some people also have other symptoms, including Facial drooping/weakness Trouble moving the eyes Drooping eyelids Trouble swallowing Slurred speech Sometimes [medlineplus.gov]
AFM symptoms include: Sudden arm or leg weakness Difficulty swallowing Slurred speech Facial weakness or drooping Loss of or weakened reflexes Headache Neck or back pain Bowel/bladder changes Respiratory symptoms (difficulty breathing) The true cause [chop.edu]
Some patients may also have cranial nerve palsies, which manifest with facial droop or weakness, difficulty moving eyes, drooping eyelids, difficulty swallowing, or slurred speech. Pain in the neck, back, arms, or legs is common. [medscape.com]
speech Sudden arm or leg weakness [8] A summary of the condition by the Centers for Disease Control and Prevention (CDC) in 2014: [9] Common features included acute focal limb weakness and specific findings on magnetic resonance imaging (MRI) of the [en.wikipedia.org]
-
Flaccid Paralysis
Acute flaccid myelitis Other names Acute flaccid paralysis with anterior myelitis, polio-like syndrome [1] Magnetic resonance imaging of the spinal cord in a case of AFM showing cord swelling in (d) which has resolved three weeks later in (e). [2] Specialty [en.wikipedia.org]
-
Guillain-Barré Syndrome
syndrome as potential causes. [en.wikipedia.org]
Workup
That workup should include MRI, spinal tap and collection of respiratory, stool and spinal fluid samples for testing. Providers should report suspected cases to their state or local health department so the CDC can track them. [aappublications.org]
Treatment
What Is the Treatment for Acute Flaccid Myelitis? There is no specific treatment for AFM. [emedicinehealth.com]
Medications typically used for the treatment of transverse myelitis (TM) have been tried in AFM with mixed results. The key to treatment of AFM is early initiation of physical and occupational therapy (PT and OT). [chop.edu]
There is no specific treatment for AFM. [1] Treatments that have been tried include immunoglobulin, corticosteroids, plasma exchange, and antiviral therapy, but there is no clear evidence that any of these treatments affect recovery. [rarediseases.info.nih.gov]
What are the treatments for acute flaccid myelitis (AFM)? 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. [medlineplus.gov]
[…] diagnosis and treatment of any person or animal. [youtube.com]
Prognosis
What Is the Recovery Time and Prognosis for Acute Flaccid Myelitis? Physical therapy and occupation therapy are especially important during recovery. The extent of recovery varies. [emedicinehealth.com]
Publications regarding longer-term outcomes and prognosis in children with acute flaccid myelitis are early in development and, thus far, only provide data for 6 to 12 months from onset. [chop.edu]
Differential diagnosis Transverse myelitis, Guillain–Barré syndrome, acute disseminated encephalomyelitis [3] [5] Prevention Polio vaccination, avoiding mosquitoes bites [5] Treatment Supportive care, physical therapy, mechanical ventilation [3] [5] Prognosis [en.wikipedia.org]
Etiology
"Acute neurologic illness of unknown etiology in children - Colorado, August-September 2014" (PDF). MMWR Morb. Mortal. Wkly. Rep. 63 (40): 901–2. PMC 4584613. PMID 25299607. [en.wikipedia.org]
Epidemiology
No epidemiologic links among patients were identified. All six patients were hospitalized. Three patients were discharged home, and two were discharged to inpatient rehabilitation facilities. [medscape.com]
"Twenty-Nine Cases of Enterovirus-D68 Associated Acute Flaccid Myelitis in Europe 2016; A Case Series and Epidemiologic Overview". The Pediatric Infectious Disease Journal. 38 (1): 16–21. doi : 10.1097/INF.0000000000002188. hdl : 11250/2588203. [en.wikipedia.org]
Prevention
Centers for Disease Control and Prevention (CDC). 22 October 2018. Retrieved 22 October 2018. [en.wikipedia.org]