Overview
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord, causing sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes. It mainly affects young children, and most cases occur after a mild respiratory illness or fever caused by a viral infection. If left untreated, AFM can progress rapidly and require hospitalization and potential breathing support from a ventilator. The condition is associated with enteroviruses, which circulate between August and November in the United States, leading to AFM outbreaks during that period. AFM symptoms can resemble those of polio, but the virus causing AFM is not the poliovirus. There is no specific way to prevent AFM, but preventing viral infections can help reduce the risk of developing the condition.
Understanding the disease
Development
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord, causing sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes. The condition mainly affects young children. AFM can be caused by an infection with a type of virus known as an enterovirus. Respiratory illnesses and fever from enteroviruses are common, especially in children. Most people recover from enterovirus infections, but in some cases, the virus can lead to the development of AFM. Outbreaks of AFM in the United States have occurred in 2014, 2016, and 2018, with the highest incidence between August and November. AFM symptoms can resemble those of polio, but it is not caused by the poliovirus.
Assessment and Diagnosis
Triage
If you or your child has symptoms of acute flaccid myelitis, such as sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes, it's important to seek immediate medical care. These symptoms can progress rapidly, and hospitalization may be necessary. In severe cases, a ventilator may be required for breathing support. If you suspect acute flaccid myelitis, consult a doctor as soon as possible.
Diagnosis
To diagnose acute flaccid myelitis, the doctor begins with a thorough medical history and physical examination. The doctor examines areas of the body where there is weakness, poor muscle tone, and decreased reflexes. They might also recommend magnetic resonance imaging (MRI), lab tests, and nerve checks to distinguish acute flaccid myelitis from other neurological conditions. Currently, there is no specific treatment for acute flaccid myelitis, and treatment is focused on managing symptoms. Patients may receive physical or occupational therapy, immunoglobulin, corticosteroids, antiviral drugs, or plasma exchange. However, the effectiveness of these treatments is not yet clear.
Management and Treatment
Prevention
No specific prevention method is available for acute flaccid myelitis. However, practicing good hygiene, such as frequent hand-washing, can help reduce the risk of viral infections, which may lead to acute flaccid myelitis. Additionally, staying up to date on recommended vaccines, including those that protect against COVID-19, influenza, and rubella, may also help in reducing the risk of developing the condition.
Home Remedies
It's important to note that acute flaccid myelitis is a serious medical condition that requires prompt medical attention. Home remedies will not be effective in treating this condition, and it's essential to seek immediate medical care if you or your child experiences symptoms related to acute flaccid myelitis.
Treatment
Currently, there is no specific treatment for acute flaccid myelitis. Treatment is aimed at managing symptoms. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) might recommend physical or occupational therapy to help with arm or leg weakness. If physical therapy is started during the initial phase of the illness, it might improve long-term recovery. The doctor might also recommend treatment with immunoglobulin, corticosteroids, or antiviral drugs. Sometimes nerve and muscle transfer surgeries are done to improve limb function. However, it's not clear whether these treatments have any benefits.
Preparing for medical consultation
To prepare for an appointment for acute flaccid myelitis, you should:
- Make a list of your symptoms, including any that may seem unrelated to the condition.
- Provide key personal information, such as recent illnesses, travel, and activities.
- List all medications, vitamins, herbs, and over-the-counter medicines that you or your child are taking, including dosages.
- Prepare a list of questions to ask your healthcare provider. These may include questions about diagnosis, treatment options, potential benefits and risks of each treatment, the role of additional specialists, and any available educational materials.
- Seek immediate medical care if you have symptoms of acute flaccid myelitis. Remember that the specific preparation steps may vary depending on your individual circumstances, so it's always best to consult with your healthcare provider for personalized guidance.