Acute flaccid myelitis (AFM): Causes-Symptoms-Diagnosis-Treatment
What is Acute flaccid myelitis (AFM)?
Acute flaccid myelitis (AFM) is an emerging neurological disorder characterized by rapid onset of flaccid paralysis and a constellation of other neurological abnormalities. AFM is caused by an infection, a reaction to a vaccination, or an auto-immune disorder. Symptoms of AFM include weakness in the arms and legs, difficulty speaking, swallowing or breathing, and loss of muscle tone or reflexes. AFM can be treated through physical, occupational and speech therapy, as well as other supportive treatments such as medications and breathing support depending on the severity of the case.
Medical terms
Acute flaccid myelitis (AFM) is a rare neurological condition that primarily affects the spinal cord and can result in sudden muscle weakness or paralysis, particularly in the limbs. AFM is characterized by the rapid onset of muscle weakness, often accompanied by other neurological symptoms. The term "acute" indicates that the condition develops rapidly, while "flaccid" refers to the limpness of the affected muscles, as opposed to spastic muscle stiffness seen in some other neurological disorders.
Key features of AFM include:
Sudden Onset: AFM typically begins abruptly, often following a viral infection, with symptoms appearing over a period of hours to days.
Muscle Weakness or Paralysis: The hallmark of AFM is muscle weakness or paralysis, which can affect one or more limbs. This weakness is often asymmetric, meaning it may affect one side of the body more than the other.
Loss of Reflexes: AFM can lead to a loss of deep tendon reflexes, such as the knee-jerk reflex, which is typically present in healthy individuals.
Pain or Discomfort: Some individuals with AFM may experience pain or discomfort in the affected areas, although this is not always the case.
Respiratory Involvement: In severe cases, AFM can affect the muscles responsible for breathing, potentially leading to respiratory distress and the need for mechanical ventilation.
Neurological Symptoms: Depending on the location and extent of spinal cord involvement, individuals with AFM may experience other neurological symptoms, such as numbness, tingling, or difficulty with coordination.
The exact cause of AFM is not fully understood, but it is believed to be associated with viral infections, particularly enteroviruses, which are common viruses that cause mild to moderate respiratory and gastrointestinal symptoms. AFM tends to occur sporadically and in clusters, with periodic outbreaks reported in various parts of the world.
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Symptoms Acute flaccid myelitis
The maximum commonplace signs and signs and symptoms of acute flaccid myelitis consist of:
Sudden arm or leg weak point
Sudden lack of muscle tone
Sudden loss of reflexes
Other feasible signs and signs and symptoms encompass:
Difficulty transferring the eyes or drooping eyelids
Facial slump or weakness
Difficulty with swallowing or slurred speech
Pain inside the fingers, legs, neck or back
Uncommon signs and symptoms might include:
Numbness or tingling
Inability to bypass urine
Severe signs involve respiratory failure, due to the muscle tissues worried in breathing becoming weak. It's additionally viable to experience lifestyles-threatening body temperature adjustments and blood pressure instability.
When to peer a physician
If you or your toddler has any of the symptoms or signs indexed above, search for hospital therapy as quickly as possible.
Causes Acute flaccid myelitis
Acute flaccid myelitis might be as a result of an infection with a form of virus called an enterovirus. Respiratory ailments and fever from enteroviruses are commonplace — specifically in kids. Most human beings get better. It's no longer clear why some human beings with an enterovirus contamination develop acute flaccid myelitis.
In the US many viruses, inclusive of enteroviruses, circulate between August and November. This is when acute flaccid myelitis outbreaks tend to arise.
The symptoms of acute flaccid myelitis can appear similar to the ones of the viral ailment polio. But none of the extreme flaccid myelitis cases within the United States had been because of poliovirus.
Risk factors Acute flaccid myelitis
Acute flaccid myelitis particularly affects young kids.
Complications Acute flaccid myelitis
Muscle weak spots resulting from acute flaccid myelitis can last for months to years.
Prevention Acute flaccid myelitis
There's no precise manner to save you acute flaccid myelitis. However, preventing viral contamination can help lessen the threat of growing acute flaccid myelitis.
Take those steps to help shield yourself or your child from getting or spreading a viral infection:
Wash your hands frequently with cleaning soap and water.
Avoid touching your face with unwashed arms.
Avoid near touch with people who are sick.
Clean and disinfect frequently touched surfaces.
Cover coughs and sneezes with a tissue or upper shirt sleeve.
Keep ill kids at home.
Diagnosis Acute flaccid myelitis
To diagnose acute flaccid myelitis, the doctor starts with a thorough medical history and bodily examination. The health practitioner may suggest:
Examining the frightened device. The medical doctor examines the locations in the body where you or your baby has weak points, bad muscle tone and reduced reflexes.
Magnetic resonance imaging (MRI). This imaging test lets in the health practitioner to study the mind and spinal wire.
Lab checks. The physician would possibly take samples of the fluid around the brain and spinal cord (cerebrospinal fluid), respiration fluid, blood, and stool for lab testing.
A nerve check. This check can take a look at how rapidly an electrical impulse acts through the nerves and the response of muscle mass to messages from the nerves.
Acute flaccid myelitis may be hard to diagnose because it shares the various identical symptoms as different neurological illnesses, including Guillain-Barre syndrome. These tests can help distinguish acute flaccid myelitis from other conditions.
Treatment Acute flaccid myelitis
Currently, there may be no unique treatment for acute flaccid myelitis. Treatment is aimed toward dealing with symptoms.
A physician who focuses on treating mind and spinal twine ailments (neurologist) may suggest bodily or occupational remedies to assist with arm or leg weak points. If bodily therapy is commenced all through the initial section of the infection, it might enhance lengthy-time period restoration.
The doctor can also suggest treatment with immunoglobulin that contains healthy antibodies from healthful donors, capsules that decrease inflammation inside the body (corticosteroids) or antiviral tablets. Or the health practitioner may suggest a treatment that gets rid of and replaces blood plasma (plasma change). However, it is no longer clean whether or not these remedies have any advantages.
Preparing for your appointment
If you have symptoms of acute flaccid myelitis, search for immediate hospital therapy.
Here's a few records to help you get prepared for your appointment.
What you could do
Make a list of the following:
Signs and signs, which include any that appear unrelated to the cause for the appointment
Any medicinal drugs, together with vitamins, herbs and over the counter drug treatments that you or your baby is taking, and their dosages
Key non-public information, inclusive of recent ailments, tour and activities
Questions to invite the physician
For acute flaccid myelitis, a few basic questions to ask the medical doctor encompass:
Will extra assessments be wished for?
What are the treatment alternatives?
What are the blessings and dangers of every remedy?
Is there one remedy you experience that is great?
Should additional professionals be visible? What will that price be, and will my coverage cover it?
Are there brochures or different published clothes that I could have? What websites do you suggest?
Don't hesitate to ask different questions that arise to you.
What to expect from your medical doctor
The health practitioner is likely to invite you or your infant several questions. Be prepared to reply to them to permit time later to cover different points you want to cope with. The health practitioner may additionally ask, as an example:
When did you or your toddler first begin experiencing signs and symptoms?
Are the symptoms continuous or occasional?
How severe are the symptoms?
What, if anything, appears to improve the signs?
What, if something, appears to get worse the symptoms?
Did you or your baby have a viral infection within the past month?
General summary
Diagnosis of AFM involves clinical evaluation by a healthcare professional, along with imaging studies like MRI to assess spinal cord abnormalities. Treatment options for AFM are limited, and management typically involves supportive care, physical therapy, and rehabilitation to help improve muscle function and mobility.
AFM is a rare condition, but it can have serious consequences, particularly in severe cases. Prompt medical evaluation and care are essential for individuals suspected of having AFM to maximize the chances of recovery and minimize complications. It's important to note that while AFM can be a serious condition, not all cases result in long-term disability, and some individuals do recover with time and rehabilitation.
