What Is Acute Flaccid Myelitis?
Acute flaccid myelitis (AFM) is a spinal cord disorder that causes muscle weakness and reflex loss. Most people who develop AFM have had a viral illness with flu-like symptoms one to four weeks before developing AFM symptoms. AFM symptoms include:
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The sudden (acute) onset of weakness in the arms or legs.
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Loss of muscle tone.
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Reduced or absent reflexes.
Pain, facial weakness, difficulty swallowing, speaking, or moving the eyes are all possible symptoms. It is unknown why some people develop AFM while others do not. The symptoms, a clinical exam, an MRI (magnetic resonance imaging) of the spine, and other laboratory testing are used to make a diagnosis. Most people with AFM experience muscle weakness for months or years. When the muscles involved in breathing become weakened, ventilator support is required to assist with breathing. The long-term prognosis for AFM patients is unknown. Treatment focuses on symptom management and includes aggressive physical therapy.
What Are the Symptoms of Acute Flaccid Myelitis?
The following are the most common signs and symptoms of acute flaccid myelitis:
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Unexpected arm or leg weakness.
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Muscle tone deterioration occurs suddenly.
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Reflexes are suddenly lost.
Other possible signs and symptoms are as follows:
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Difficulty moving the eyes or droopy eyelids.
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Face drooping or weakness.
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Swallowing difficulties or slurred speech.
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Aches and pains in the arms, legs, neck, or back.
The following are some unusual symptoms:
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Tingling or numbness.
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Urinary incontinence.
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Severe symptoms include respiratory failure caused by the weakening the muscles involved in breathing. It is also possible to have life-threatening body temperature and blood pressure changes.
Symptoms typically appear one to four weeks following a flu-like illness (fever, cough, stomach distress). Children are more likely than adults to be affected. Muscle weakness develops quickly and can affect one to four limbs. The arms are more prone to being affected. Sometimes the muscles involved in breathing become weak, necessitating mechanical breathing support (a ventilator). Most people who develop AFM experience symptoms for months or even years. Because AFM was only recently described, little is known about its long-term consequences.
What Are the Causes of Acute Flaccid Myelitis?
An infection may cause acute flaccid myelitis with an enterovirus type of virus. Respiratory illnesses and fever caused by enteroviruses are common, particularly in children. The majority of people recover. It is unknown why some people with an enterovirus infection develop acute flaccid myelitis. Acute flaccid myelitis symptoms can resemble those of the viral disease polio. However, no cases of acute flaccid myelitis in the United States have been linked to poliovirus.
How Can Acute Flaccid Myelitis Be Prevented?
Viruses, including enteroviruses, can cause AFM. Enteroviruses are common and typically cause only minor illnesses. There is no specific method to prevent AFM because we don't know what causes it in a human. However, individuals can take precautions to avoid becoming ill from a virus. The chances of contracting the virus can be reduced by doing the following:
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Wash hands with soap and water for at least 20 seconds regularly.
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Avoid using unwashed hands to touch the face.
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Avoiding close contact with sick people.
One can reduce the spread of a virus by doing the following:
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Cleaning and disinfecting surfaces frequently touched, such as toys, mobile devices, and doorknobs.
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Coughs and sneezes should be covered with a tissue or upper shirt sleeve, not the hands.
How Is AFM Diagnosed and Treated?
Clinicians diagnose AFM by taking a detailed medical history, performing a physical exam, and using an MRI (magnetic resonance imaging) to examine images of the spinal cord. Currently, there is no specific treatment for AFM, but clinicians may recommend different interventions based on each patient's needs. Diagnostic tests must be performed immediately after a patient develops symptoms. AFM is difficult to diagnose because it shares many symptoms with other neurologic diseases, such as transverse myelitis and Guillain-Barre syndrome. Clinicians should consider consulting with neurology and infectious disease specialists to help with AFM diagnosis. Clinicians can distinguish AFM from other neurologic conditions using testing and examinations. The following tests can be used to aid in the diagnosis of AFM:
Examination of the Nervous System:
A clinician can examine a patient's nervous system and the areas of the body with weakness, poor muscle tone, and decreased reflexes.
MRI (Magnetic Resonance Imaging):
A clinician can also perform an MRI on a patient's brain and spinal cord to look for changes in the grey matter of the spinal cord that could indicate AFM.
Laboratory Examinations:
A clinician may perform laboratory tests on cerebrospinal fluid (the fluid surrounding the brain and spinal cord) to look for signs of inflammation.
Nerve Conduction Test:
A clinician may examine nerve conduction (the transmission of an impulse and a nerve fiber) and response to help determine where the weakness occurs.
What Is the Treatment for AFM?
AFM does not have a specific treatment, but a clinician specializing in diseases like AFM may recommend specific interventions on a case-by-case basis. Clinicians may, for example, recommend physical or occupational therapy to help with arm or leg weakness caused by AFM. Physical rehabilitation may improve long-term outcomes if started early in the illness.
Conclusion:
The long-term prognosis for AFM patients is unknown. People with mild AFM symptoms may have a better prognosis than those with severe symptoms. Some people may be able to recover completely and quickly. Most people suffer from muscle weakness that lasts for a long time. If anyone in the family experiences a leg or arm that suddenly becomes weak and does not function properly, they should seek medical attention immediately. If anyone notices any other symptoms, such as problems with their face, mouth, or eyes, they should contact their doctor immediately. Breathing difficulties always necessitate immediate medical attention.
