BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAcute flaccid myelitisAcute flaccid myelitis; AFM; Polio-like syndrome; Acute flaccid paralysis; Acute flaccid paralysis with anterior myelitis; Anterior myelitis; Enterovirus D68; Enterovirus A71 Acute flaccid myelitis is a rare condition that affects the nervous system. Inflammation of the gray matter in the spinal cord leads to muscle weakness and paralysis.Acute flaccid myelitis (AFM) is usually caused by infection with a virus. While AFM is rare, there has been a slight increase in cases of AFM since 2014. Most new cases have occurred in children or young adults. Causes AFM usually occurs after a cold, fever, or gastrointestinal illness.Different kinds of viruses may be the cause of AFM. These include:Enteroviruses (poliovirus and non-poliovirus) West Nile virus and similar viruses such as Japanese encephalitis virus and Saint Louis encephalitis virus AdenovirusesIt is unclear why certain viruses trigger AFM, or why some people develop the condition and others don't.Environmental toxins also can cause AFM. In many cases, a cause is never found. Symptoms A fever or a respiratory illness is often present before weakness and other symptoms begin.AFM symptoms often start with sudden muscle weakness and loss of reflexes in an arm or leg. Symptoms may progress rapidly over a few hours to days. Other symptoms may include:Facial droop or weakness Drooping eyelids Difficulty moving the eyes Slurred speech or difficulty swallowingSome people may have:Stiffness in the neck Pain in the arms or legs Inability to pass urineSevere symptoms include:Respiratory failure, when muscles involved in breathing become weak Serious nervous system problems, which may lead to death Exams and Tests Your health care provider will take your medical history and vaccination history to know if you are up-to-date with your polio vaccines. Unvaccinated individuals who are exposed to poliovirus are at higher risk for acute flaccid myelitis. Your provider also may want to know if within the last 4 weeks you have:Traveled Had a cold or the flu or a stomach bug Had a fever 100°F (38°C) or higherYour provider will do a physical exam. Tests that may be done include:MRI of spine and MRI of the brain to view lesions in the gray matter MRI of spineA cervical MRI (magnetic resonance imaging) scan uses energy from strong magnets to create pictures of the part of the spine that runs through the ne...Read Article Now Book Mark Article MRI of the brainA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Nerve conduction velocity test Nerve conduction velocity testNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Electromyography (EMG) Electromyography (EMG)Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysis to check if white blood cells are elevatedCerebrospinal fluid (CSF) analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article Your provider also may take stool, blood, and saliva samples to test. Treatment There is no specific treatment for AFM. You may be referred to a doctor specializing in disorders of the nerves and nervous system (neurologist). The doctor will likely treat your symptoms.A number of medicines and treatments that work on the immune system have been tried but have not been found to help.You may need physical therapy to help restore muscle function. Outlook (Prognosis) The long-term outlook of AFM is not known. Possible Complications Complications of AFM include:Muscle weakness and paralysis Loss of limb function When to Contact a Medical Professional Contact your provider right away if you or your child have:Sudden weakness in the arms or legs or difficulty moving the head or face Any other symptom of AFM Prevention There is no known way to prevent AFM. Having a polio vaccine may help reduce the risk of AFM related to the poliovirus.Polio vaccineAll content below is taken in its entirety from the CDC Polio Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-statements/ipv....ImageRead Article Now Book Mark Article Take these steps to help avoid viral infections:Wash hands frequently with soap and water, especially before eating. Avoid close contact with people who have a viral infection. Use mosquito repellants when going outdoors to prevent mosquito bites.To learn more and get recent updates, go to the CDC webpage about acute flaccid myelitis at www.cdc.gov/acute-flaccid-myelitis/index.html.Open ReferencesReferencesCenters for Disease Control and Prevention website. Acute flaccid myelitis. www.cdc.gov/acute-flaccid-myelitis/index.html. Updated June 21, 2022. Accessed December 2, 2022.Kapadia RK, Pastula DM, Glaser CA. Parainfectious and postinfectious neurologic syndromes. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 45.Messacar K, Abzug MJ. Enteroviruses and parechoviruses. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 236.AllVideoImagesTogMRI scans - illustration MRI stands for magnetic resonance imaging. It allows imaging of the interior of the body without using x-rays or other types of ionizing radiation. An MRI scan is capable of showing fine detail of different tissues.MRI scansillustrationCSF chemistry - illustration Cerebrospinal fluid (CSF) is a clear fluid that circulates in the space surrounding the spinal cord and brain. CSF protects the brain and spinal cord from injury by acting like a liquid cushion. CSF is usually obtained through a lumbar puncture (spinal tap). During the procedure, a needle is inserted usually between the third and fourth lumbar vertebrae and the CSF fluid is collected for testing.CSF chemistryillustrationElectromyography - illustration Electromyography is a test that measures muscle response to nervous stimulation. A needle electrode is inserted through the skin into the muscle. Each muscle fiber that contracts will produce an action potential. The presence, size, and shape of the wave form of the action potential produced on the oscilloscope, provides information about the ability of the muscle to respond to nervous stimulation.ElectromyographyillustrationMRI scans - illustration MRI stands for magnetic resonance imaging. It allows imaging of the interior of the body without using x-rays or other types of ionizing radiation. An MRI scan is capable of showing fine detail of different tissues.MRI scansillustrationCSF chemistry - illustration Cerebrospinal fluid (CSF) is a clear fluid that circulates in the space surrounding the spinal cord and brain. CSF protects the brain and spinal cord from injury by acting like a liquid cushion. CSF is usually obtained through a lumbar puncture (spinal tap). During the procedure, a needle is inserted usually between the third and fourth lumbar vertebrae and the CSF fluid is collected for testing.CSF chemistryillustrationElectromyography - illustration Electromyography is a test that measures muscle response to nervous stimulation. A needle electrode is inserted through the skin into the muscle. Each muscle fiber that contracts will produce an action potential. The presence, size, and shape of the wave form of the action potential produced on the oscilloscope, provides information about the ability of the muscle to respond to nervous stimulation.ElectromyographyillustrationRelated Information Review Date: 11/2/2022 Reviewed By: Evelyn O. Berman, MD, Assistant Professor of Neurology and Pediatrics at University of Rochester, Rochester, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Acute flaccid myelitisAcute flaccid myelitis; AFM; Polio-like syndrome; Acute flaccid paralysis; Acute flaccid paralysis with anterior myelitis; Anterior myelitis; Enterovirus D68; Enterovirus A71 Acute flaccid myelitis is a rare condition that affects the nervous system. Inflammation of the gray matter in the spinal cord leads to muscle weakness and paralysis.Acute flaccid myelitis (AFM) is usually caused by infection with a virus. While AFM is rare, there has been a slight increase in cases of AFM since 2014. Most new cases have occurred in children or young adults. Causes AFM usually occurs after a cold, fever, or gastrointestinal illness.Different kinds of viruses may be the cause of AFM. These include:Enteroviruses (poliovirus and non-poliovirus) West Nile virus and similar viruses such as Japanese encephalitis virus and Saint Louis encephalitis virus AdenovirusesIt is unclear why certain viruses trigger AFM, or why some people develop the condition and others don't.Environmental toxins also can cause AFM. In many cases, a cause is never found. Symptoms A fever or a respiratory illness is often present before weakness and other symptoms begin.AFM symptoms often start with sudden muscle weakness and loss of reflexes in an arm or leg. Symptoms may progress rapidly over a few hours to days. Other symptoms may include:Facial droop or weakness Drooping eyelids Difficulty moving the eyes Slurred speech or difficulty swallowingSome people may have:Stiffness in the neck Pain in the arms or legs Inability to pass urineSevere symptoms include:Respiratory failure, when muscles involved in breathing become weak Serious nervous system problems, which may lead to death Exams and Tests Your health care provider will take your medical history and vaccination history to know if you are up-to-date with your polio vaccines. Unvaccinated individuals who are exposed to poliovirus are at higher risk for acute flaccid myelitis. Your provider also may want to know if within the last 4 weeks you have:Traveled Had a cold or the flu or a stomach bug Had a fever 100°F (38°C) or higherYour provider will do a physical exam. Tests that may be done include:MRI of spine and MRI of the brain to view lesions in the gray matter MRI of spineA cervical MRI (magnetic resonance imaging) scan uses energy from strong magnets to create pictures of the part of the spine that runs through the ne...Read Article Now Book Mark Article MRI of the brainA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article Nerve conduction velocity test Nerve conduction velocity testNerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...ImageRead Article Now Book Mark Article Electromyography (EMG) Electromyography (EMG)Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) analysis to check if white blood cells are elevatedCerebrospinal fluid (CSF) analysisCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article Your provider also may take stool, blood, and saliva samples to test. Treatment There is no specific treatment for AFM. You may be referred to a doctor specializing in disorders of the nerves and nervous system (neurologist). The doctor will likely treat your symptoms.A number of medicines and treatments that work on the immune system have been tried but have not been found to help.You may need physical therapy to help restore muscle function. Outlook (Prognosis) The long-term outlook of AFM is not known. Possible Complications Complications of AFM include:Muscle weakness and paralysis Loss of limb function When to Contact a Medical Professional Contact your provider right away if you or your child have:Sudden weakness in the arms or legs or difficulty moving the head or face Any other symptom of AFM Prevention There is no known way to prevent AFM. Having a polio vaccine may help reduce the risk of AFM related to the poliovirus.Polio vaccineAll content below is taken in its entirety from the CDC Polio Vaccine Information Statement (VIS): www. cdc. gov/vaccines/hcp/vis/vis-statements/ipv....ImageRead Article Now Book Mark Article Take these steps to help avoid viral infections:Wash hands frequently with soap and water, especially before eating. Avoid close contact with people who have a viral infection. Use mosquito repellants when going outdoors to prevent mosquito bites.To learn more and get recent updates, go to the CDC webpage about acute flaccid myelitis at www.cdc.gov/acute-flaccid-myelitis/index.html.Open ReferencesReferencesCenters for Disease Control and Prevention website. Acute flaccid myelitis. www.cdc.gov/acute-flaccid-myelitis/index.html. Updated June 21, 2022. Accessed December 2, 2022.Kapadia RK, Pastula DM, Glaser CA. Parainfectious and postinfectious neurologic syndromes. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 45.Messacar K, Abzug MJ. Enteroviruses and parechoviruses. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 236.