🧠 Acute Flaccid Myelitis (AFM)
Acute Flaccid Myelitis (AFM) is a rare but serious neurological condition that affects the spinal cord, causing sudden muscle weakness and paralysis—especially in children. It resembles polio but is caused by different viruses, primarily non-polio enteroviruses.
🧬 Causes:
- Most common cause: Enterovirus D68 (EV-D68)
- Other viruses: Enterovirus A71, West Nile virus, adenovirus
- Exact mechanism: Virus infects or triggers inflammation in the gray matter of the spinal cord
🩺 Symptoms:
AFM often starts like a viral illness and progresses rapidly:
- Initial (mild) symptoms:
- Fever
- Cough, congestion
- Gastrointestinal symptoms
- Neurological symptoms (usually 3–10 days later):
- Sudden limb weakness (often asymmetrical)
- Loss of muscle tone and reflexes
- Facial droop, slurred speech
- Difficulty moving eyes or swallowing
- In severe cases: respiratory failure (due to muscle weakness)
🔍 Diagnosis:
- MRI of the spinal cord: shows lesions in the gray matter
- Lumbar puncture: to detect inflammation in cerebrospinal fluid
- Viral testing: throat swabs, stool, blood, and spinal fluid samples
- Neurological exam: to assess strength and reflexes
💊 Treatment:
- No specific antiviral or cure currently
- Supportive care is critical:
- Physical and occupational therapy
- Ventilator support if breathing is affected
- Steroids, IVIG, or plasma exchange (used in some cases, but benefit unclear)
- Recovery varies—some improve significantly; others have long-term weakness
⚠️ Complications:
- Permanent paralysis
- Respiratory failure
- Loss of mobility or limb function
- Psychological and social impacts (especially in children)
🧼 Prevention:
- Practice good hygiene: handwashing, disinfecting surfaces
- Keep children home when sick
- No vaccine for AFM, but polio vaccination is critical to rule out polio-related paralysis
- Monitoring during enterovirus season (late summer to fall)