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Polio-Like Acute Flaccid Myelitis Is Scary, but Rare

acute flaccid myelitis
The cause of AFM is still unknown. However, most patients will have a respiratory illness days or weeks prior to developing AFM.

If you’ve tuned into the news lately, you may have heard about a rare, polio-like disease affecting children. In 2018, the Centers for Disease Control and Prevention confirmed 233 acute flaccid myelitis (AFM) cases in the U.S. Since many cases occur in late summer and early fall, the CDC is urging providers to watch for symptoms.

Still, AFM is very rare, so pediatric neurologist J. Nicholas Brenton, MD, advises parents to get more information before worrying too much.

We talked to Brenton about the prevalence of AFM, signs and symptoms of the disease and more in the Q&A below.

Acute Flaccid Myelitis: Frequently Asked Questions

What is acute flaccid myelitis?

AFM is a rare but serious neurologic condition that typically affects young children. The cause of AFM is still unknown. However, most patients will have a respiratory illness days or weeks prior to developing AFM.

Look for these signs:

  • Flaccid weakness in one or more of the limbs
  • Facial weakness
  • Impaired movement of the eyes

These symptoms typically progress rapidly over hours to days until they plateau. In very severe cases, the condition may progress so far that it impacts the muscles that control breathing.

Is Your Child Experiencing Symptoms of AFM?

Don’t wait. Visit the UVA Children’s Hospital emergency room.

How is AFM diagnosed?

There is no single test to identify this condition. The key to an accurate diagnosis is to first rule out other possible causes of these debilitating symptoms, such as an infection or an inflammatory/autoimmune disorder.

In addition to a clinical exam, doctors will do an MRI of the spinal cord, which often shows abnormalities that suggest AFM. To help rule out other causes and confirm suspicion for AFM, doctors will likely run tests on the blood and spinal fluid.

Is there a treatment for AFM?

Doctors may use:

  • Corticosteroids
  • Intravenous immunoglobulin infusion therapy (IVIg), which involves injecting infection-fighting antibodies into the bloodstream

It is important to note that there’s currently no strong scientific evidence to support the benefits of these treatments in AFM. In fact, some physicians may consider the risks of these treatments to outweigh any potential benefit. The primary goal is stabilizing the patient during the acute phase of the illness.

Once the child is stable, we encourage intense physical and occupational therapy to optimize long-term outcomes. Though nearly all patients grow stronger over time, the majority will have persistent weakness in the affected limb or limbs at one year from onset.

What’s the key takeaway for concerned parents?

This condition is rare. Less than one in one million kids will be diagnosed in the U.S., according to the CDC. There’s no way to prevent AFM, but we do encourages families to practice good health hygiene with their children:

  • Stay up-to-date on recommended vaccinations
  • Wash hands often
  • Take your child to the doctor if they show any AFM signs or symptoms

There are many other diagnostic possibilities beyond AFM, so I encourage parents to be proactive.

This post was originally published in December 2018 and updated on July 11, 2019. 

Tags: neuro

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