Acute flaccid myelitis (AFM) may spread from one person to another through mosquitoes. AFM may be caused by several different types of viruses, toxins, and genetics. Often, the cause of a patient’s AFM may not be identified. Anyone of any age may get AFM, but it is more commonly reported in children. As per research, sometimes, the entire family may be sick, but only one member (most probably a child) may be most severely affected by AFM. The virus may be contagious, but a few people are most susceptible to developing symptoms and complications.
What is acute flaccid myelitis (AFM)?
Acute flaccid myelitis (AFM) is rare but a serious medical condition that affects the nervous system, specifically the spinal cord. Most acute flaccid myelitis cases have been in young children (the average age is 3-15 years). This condition usually affects the gray matter in the spinal cord, which weakens the body’s muscles and reflexes. This can lead to paralysis that is sometimes permanent. The common signs and symptoms include:
- Stiff neck
- Sudden arm or leg weakness with or without pain
- Difficulty swallowing
- Slurred speech
- Facial weakness or drooping of eyelids
- Loss of or weakened reflexes
- Neck or back pain
- Bowel/bladder changes
- Respiratory symptoms (difficulty breathing)
- Difficulty moving the eyes or drooping eyelids
- Difficulty with swallowing or slurred speech
- Bowel or bladder control problems
How is AFM diagnosed?
AFM can be difficult to diagnose because the symptoms are similar to other neurological diseases. AFM may be diagnosed by:
- Physical examination: Looking at the location of the weakness, muscle tone, and reflexes
- Magnetic resonance imaging (MRI)
- Laboratory tests: Biological specimens, including cerebrospinal fluid (CSF), serum, and stool
Is there a treatment for AFM?
Unfortunately, there is no available treatment for AFM; however, a few options may help in relieving the symptoms:
- Initially, patients are treated with supportive care, physical therapy (PT), and occupational therapy (OT). Early intervention may begin to restore functions of the affected limbs and improve daily functioning, even if it is not possible to regain full muscle function. Patients can continue to improve with PT and OT for months to years following their initial illness.
- Certain therapies that have been tried, such as immunoglobulin, plasma exchange, corticosteroids, and antiviral therapy. The main purpose of utilizing these therapies is to decrease the inflammation and halt the body’s immune system from initiating further attacks. However, there is no concrete evidence that immune-modulating therapies have remarkable effects on AFM patients.
- Occasionally, mechanical ventilation is required to support breathing.
- If muscle movement does not come back, a surgical procedure can be performed to help. These are called nerve transfers. A nerve transfer involves finding a healthy working nerve and connecting it to a nonworking muscle. In time, the working nerve grows into the muscle, and then over time (9-12 months) movement can happen. This helps to rewire the nerves to give the patient better movement and strength in their limbs.
What is the outlook of patients with AFM?
The outlook is poor for AFM due to the lack of definite causative agents. The recovery is unpredictable and may range from full recovery in a matter of days to long-term limb weakness. As per research, patients regain some strength over time, many do not recover to gain full function. The most involved extremity (arm/leg) is generally least likely to recover.
What are the best ways to prevent acute flaccid myelitis?
The following measures may be taken to protect an individual from contracting an infection:
- Getting the required vaccinations on time
- Minimizing exposure to mosquitoes may help prevent the infection
- Following certain basic hygiene procedures, such as washing the hands with soap and water, disinfecting touched items, and avoiding contact with contagious people, may help reduce the chances of acquiring an infection.