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Acute flaccid myelitis (AFM)
Acute flaccid myelitis (AFM) is a condition that affects the spinal cord leading to muscle weakness and loss of reflexes
Prevalence
<1 per 1,000,000
~30–200
US Estimated
Rare / sporadic
Europe Estimated
Age of Onset
Childhood
ICD-10
G04.89
Inheritance
Autosomal dominant
Autosomal recessive
Mitochondrial/Multigenic
X-linked dominant
X-linked recessive
5 Facts you should know
FACT
AFM affects the spinal cord, leading to muscle weakness and loss of reflexes
FACT
Most people who develop AFM have had a viral illness with flu-like symptoms 1 to 4 weeks before symptoms of AFM
FACT
Symptoms of AFM include sudden onset (acute) of weakness in the arm(s) or leg(s), loss of muscle tone, and decreased or absent reflexes
FACT
AFM is rare, but an increasingly recognized cause of paralysis, occurring primarily in children
FACT
5
The underlying mechanism involves damage to the spinal cord's grey matter
Rare View
A rare neurological condition characterized by sudden onset of limb weakness, loss of muscle tone, and diminished reflexes, often following a viral infection. It primarily affects children and can lead to paralysis.
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Common signs & symptoms
Early symptoms may include:
- Fever
- Respiratory illness
- Runny nose
Neurologic symptoms may follow within days:
- Sudden limb weakness
- Loss of muscle tone (flaccid paralysis)
- Decreased or absent reflexes
- Facial weakness
- Difficulty swallowing or speaking
- Drooping eyelids
- Difficulty breathing in severe cases
Current treatments
There is no specific antiviral treatment proven to cure AFM.
Management focuses on supportive care and rehabilitation:
- Hospitalization and monitoring
- Respiratory support when needed
- Physical therapy
- Occupational therapy
- Rehabilitation programs
Experimental treatments sometimes considered include:
- Intravenous immunoglobulin (IVIG)
- Corticosteroids
- Plasma exchange
References:
Messacar K, Schreiner TL, Van Haren K, et al. Acute flaccid myelitis: a clinical review of US cases 2012–2015. Ann Neurol. 2016;80(3):326–338. doi:10.1002/ana.24721 Sejvar JJ, Lopez AS, Cortese MM, et al. Acute flaccid myelitis in the United States, August–December 2014: results of nationwide surveillance. Clin Infect Dis. 2016;63(6):737–745. doi:10.1093/cid/ciw372 Maloney JA, Mirsky DM, Messacar K, et al. MRI findings in children with acute flaccid myelitis. AJNR Am J Neuroradiol. 2015;36(2):258–263. doi:10.3174/ajnr.A4189 Centers for Disease Control and Prevention (CDC). Acute Flaccid Myelitis: clinical overview and surveillance reports.