Acute flaccid myelitis: cause, diagnosis, and management

Acute flaccid myelitis (AFM) is a severe illness, similar to polio, that primarily affects children, leading to muscle weakness. Outbreaks have occurred globally since 2012, and non-polio enterovirus infections are thought to be the cause. Diagnosing AFM involves identifying specific clinical, neuroimaging, and cerebrospinal fluid characteristics, as there isn't a single definitive test. After the initial phase, individuals with AFM often face significant long-term disabilities and require specialized rehabilitation to improve their functional status and quality of life.

• 1
  Enterovirus D68 is strongly linked to AFM outbreaks, supported by temporal and geographical correlations, its prevalence in AFM patients' samples, and recent strains showing increased neurovirulence in models.
• 2
  MRI of the spinal cord is the most important diagnostic tool, revealing T2 hyperintensity in the spinal cord grey matter.
• 3
  AFM often results in substantial residual weakness and muscle atrophy, necessitating comprehensive rehabilitation and potentially surgical interventions like nerve transfers to improve function.