Acute Flaccid Myelitis (AFM): Symptoms and Causes

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Acute Flaccid Myelitis Symptoms: Acute Flaccid Myelitis (AFM) is an uncommon but serious neurologic condition that affects the nervous system, particularly the area of the spinal cord called gray matter.

This condition causes the muscles and reflexes in the body to become weak. Below, we delve into the critical aspects of AFM, providing a comprehensive overview of its symptoms and causes.

Understanding Acute Flaccid Myelitis

AFM is characterized by a sudden onset of arm or leg weakness and loss of muscle tone and reflexes. The severity of these symptoms can vary significantly from one individual to another, with some patients experiencing mild difficulty in moving the limbs while others may face complete paralysis. The hallmark of AFM is the rapid progression of muscle weakness, which reaches its peak within hours to days.

Recognizing the Symptoms of Acute Flaccid Myelitis

The initial symptoms of AFM are similar to those of other viral illnesses and may include:

  • Fever
  • Respiratory illness
  • Gastrointestinal issues

As AFM progresses, additional signs and symptoms may manifest, including:

  • Facial droop/weakness
  • Difficulty moving the eyes
  • Drooping eyelids
  • Difficulty with swallowing
  • Slurred speech

In severe cases, AFM can lead to respiratory failure when the muscles involved with breathing become weakened. This is a medical emergency requiring immediate intervention.

Causes of Acute flaccid myelitis (AFM)

While the exact cause of AFM remains uncertain, epidemiologists have linked several factors to the condition:

  • Viral infections, particularly those caused by enteroviruses such as EV-D68 and EV-A71, are the most commonly identified precedents of AFM.
  • Environmental toxins and genetic disorders are also being explored as potential contributors to the development of AFM.

The Enterovirus Connection

A significant amount of research points towards enteroviruses, specifically non-polio enteroviruses, as being closely related to the increase in AFM cases, especially in children. These viruses are common and can cause respiratory illness, fever, and, in rare cases, neurological conditions.

Epidemiological Trends: The Occurrence of AFM

AFM is most prevalent in children and has been known to occur in waves, notably between August and October. The Centers for Disease Control and Prevention (CDC) has observed an increase in cases every two years, particularly in the late summer to early fall, correlating with enterovirus season in the United States.

Prevention of Acute Flaccid Myelitis

There’s no specific way to prevent acute flaccid myelitis. However, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis.

Take these steps to help protect yourself or your child from getting or spreading a viral infection:

  • Wash your hands often with soap and water.
  • Avoid touching your face with unwashed hands.
  • Avoid close contact with people who are sick.
  • Clean and disinfect frequently touched surfaces.
  • Cover coughs and sneezes with a tissue or upper shirt sleeve.
  • Keep sick children at home.

Diagnosis: Detecting AFM Early

Early diagnosis of AFM is critical for the management and treatment of the condition. Physicians will typically perform a thorough neurological examination and may order various tests including:

  • Magnetic resonance imaging (MRI) to look for abnormalities in the spinal cord
  • Lumbar puncture to analyze cerebrospinal fluid
  • Electromyography (EMG) to assess the electrical activity of muscles
  • Laboratory tests on respiratory, blood, and stool samples to identify a potential viral cause

Treatment: Approaching AFM Management

Currently, there is no specific treatment for AFM, but a neurologist may recommend certain interventions depending on the symptoms and severity, including:

  • Physical and occupational therapy to regain strength and mobility
  • Pain management strategies
  • Respiratory support if breathing muscles are affected

Preventive Strategies: Reducing the Risk of AFM

Prevention of AFM centers around avoiding the known causes and boosting immune system defenses. Recommended preventive measures include:

  • Practicing good hygiene, such as handwashing to avoid the spread of viruses
  • Staying up to date on vaccinations, including poliovirus and others that protect against respiratory illnesses
  • Protecting against mosquito-borne viruses by using repellent and staying indoors during peak mosquito activity hours

The Future of AFM: Research and Hope

Researchers continue to investigate AFM to better understand its causes and find effective treatments. With increased awareness and improved surveillance, the medical community is becoming more adept at identifying and managing this condition.

Preparing for your appointment

If you have symptoms of acute flaccid myelitis, seek immediate medical care.

Here’s some information to help you get ready for your appointment.

What you can do

Make a list of the following:

  • Signs and symptoms, including any that seem unrelated to the reason for the appointment
  • Any medications, including vitamins, herbs and over-the-counter medicines that you or your child is taking, and their dosages
  • Key personal information, including recent illnesses, travel and activities
  • Questions to ask the doctor

For acute flaccid myelitis, some basic questions to ask the doctor include:

  • Will additional tests be needed?
  • What are the treatment options?
  • What are the benefits and risks of each treatment?
  • Is there one treatment you feel is best?
  • Should additional specialists be seen? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can have? What websites do you recommend?

Don’t hesitate to ask other questions that occur to you.

What to expect from your doctor

The doctor is likely to ask you or your child several questions. Be ready to answer them to allow time later to cover other points you want to address. The doctor may ask, for example:

  • When did you or your child first begin experiencing symptoms?
  • Are the symptoms continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve the symptoms?
  • What, if anything, appears to worsen the symptoms?
  • Did you or your child have a viral infection in the past month?

In conclusion, Acute Flaccid Myelitis is a rare, yet significant condition that requires prompt medical attention and intervention. Understanding the symptoms and potential causes is crucial for early detection and management. Continuous research and preventive measures are vital in the fight against AFM and in ensuring the health and safety of those potentially affected.