TY - JOUR
T1 - Acute flaccid myelitis
T2 - cause, diagnosis, and management
AU - AFM working group
AU - Murphy, Olwen C.
AU - Messacar, Kevin
AU - Benson, Leslie
AU - Bove, Riley
AU - Carpenter, Jessica L.
AU - Crawford, Thomas
AU - Dean, Janet
AU - DeBiasi, Roberta
AU - Desai, Jay
AU - Elrick, Matthew J.
AU - Farias-Moeller, Raquel
AU - Gombolay, Grace Y.
AU - Greenberg, Benjamin
AU - Harmelink, Matthew
AU - Hong, Sue
AU - Hopkins, Sarah E.
AU - Oleszek, Joyce
AU - Otten, Catherine
AU - Sadowsky, Cristina L.
AU - Schreiner, Teri L.
AU - Thakur, Kiran T.
AU - Van Haren, Keith
AU - Carballo, Carolina M.
AU - Chong, Pin Fee
AU - Fall, Amary
AU - Gowda, Vykuntaraju K.
AU - Helfferich, Jelte
AU - Kira, Ryutaro
AU - Lim, Ming
AU - Lopez, Eduardo L.
AU - Wells, Elizabeth M.
AU - Yeh, E. Ann
AU - Pardo, Carlos A.
AU - Salazar-Camelo, Andrea
AU - Mithal, Divakar
AU - Wilson-Murphy, Molly
AU - Bauer, Andrea
AU - Watkins, Colyn
AU - Abzug, Mark
AU - Dominguez, Samuel
AU - Melicosta, Michelle
AU - Tunney, Margaret
AU - Duggal, Priya
AU - Pekosz, Andrew
AU - Belzberg, Allan
AU - Bembea, Melania
AU - Riggs, Rebecca
AU - Nance, Jessica
AU - Milstone, Aaron
AU - Lazerow, Peggy
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/1/23
Y1 - 2021/1/23
N2 - Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host–virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.
AB - Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host–virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.
UR - http://www.scopus.com/inward/record.url?scp=85099040803&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099040803&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(20)32723-9
DO - 10.1016/S0140-6736(20)32723-9
M3 - Review article
C2 - 33357469
AN - SCOPUS:85099040803
SN - 0140-6736
VL - 397
SP - 334
EP - 346
JO - The Lancet
JF - The Lancet
IS - 10271
ER -