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Acute flaccid myelitis (AFM) is a condition characterized by muscle weakness and myelitis, a medical term used to describe inflammation of the spinal cord. It is a rare disease affecting the gray matter, area of the brain responsible for muscle control and sensory perception.
The AFM is clbadified as a subtype or variant of transverse myelitis, which clinically presents symptoms and signs typical of neurological dysfunction of the sensory and motor pathways on both sides of the spinal cord.
Although the disease is mainly observed in older children (median age 7 years), AFM can also develop in adults.
What are the causes of acute flaccid myelitis?
Although no specific cause of MFA has been discovered to date, some viruses have been badociated with the development of this serious disease. Viruses such as enterovirus A71, West Nile virus and poliovirus have been shown to be potentially involved in the pathogenesis of AFM. In 2014, an outbreak of respiratory disease badociated with enterovirus D68 was reported in the United States. During this outbreak, a group of MFA cases was also found in Colorado and California.
The symptoms badociated with AFM usually develop after a prodromal illness. However, the exact mechanism responsible for triggering the trigger is still unknown. Sometimes the cerebrospinal fluid of the affected person does not contain any trace of pathogens.
How is acute flaccid myelitis (AFM) diagnosed?
The symptoms badociated with AFM are often similar to those of other neurological conditions, such as transverse myelitis and Guillain-Barré syndrome (GBS). This makes difficult the differential diagnosis of AFM. However, some tests and neurological examinations can help a quick diagnosis of the disease.
Symptoms of AFM
A typical diagnostic strategy includes a complete physical examination, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) tests, electromyographic or electrodiagnostic tests, and nerve conduction velocity tests. Airway samples may be examined for the presence of any responsible viral component.
Lesions suggestive of spinal injury are found in MRI scans. Motor neuropathy or neuronopathy is described in electromyography. The tests do not usually reveal any sensory abnormalities because the myelitis is limited to the gray matter of the spinal cord.
Cerebrospinal fluid (CSF) tests in most patients show pleocytosis or abnormal amounts of white blood cells. Proteins between 19 and 99 mg / dL may also be present in the CSF.
According to the Centers for Disease Control and Prevention (CDC), the diagnosis of AFM requires two criteria:
- Acute asymmetric flaccid paralysis characterized by weakness, and
- Lesions specifically in the gray matter of the brain in MRI comprising one or more segments of the spine.
Since the final causative agent of AFM is not known, there is no vaccine to prevent it. Current treatment strategies usually involve physical and professional therapies to manage limb weakness. The long-term effects of this rare disease are urgently needed, and research is directed to this need, as well as to a better understanding of the disease and its pathogenesis.
Further reading
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