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Increase in Acute Flaccid Myelitis - United States, 2018

MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT (2018)

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MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT

卷 67, 期 45, 页码 1273-1275

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CENTERS DISEASE CONTROL

DOI: 10.15585/mmwr.mm6745e1

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Enterovirus D68 in the Anterior Horn Cells of a Child with Acute Flaccid Myelitis

Matthew R. Vogt, Peter F. Wright, William F. Hickey, Tristan De Buysscher, Kelli L. Boyd, James E. Crowe

Summary: This study reveals the presence of EV-D68 RNA and protein in anterior horn cells and their axons in a child who died from an acute flaccid myelitis-like illness, strongly indicating the virus as the cause of the disorder.

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Article Clinical Neurology

Comparison of acute flaccid myelitis and transverse myelitis in children and evaluation of diagnostic criteria

Jelte Helfferich, Arlette L. Bruijstens, Marjolein Knoester, Oebele F. Brouwer, Rinze F. Neuteboom

Summary: This study compared the clinical features of pediatric acute flaccid myelitis (AFM) and transverse myelitis (TM) and evaluated the current diagnostic criteria. The results showed important differences in clinical and diagnostic features between AFM and TM, emphasizing the importance of thorough clinical examination and early and accurate diagnostic studies.

EUROPEAN JOURNAL OF NEUROLOGY (2023)

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Article Surgery

Characteristics of Upper Extremity Recovery in Acute Flaccid Myelitis: A Case Series

Erin L. Weber, Julie M. Werner, Maxwell B. Johnson, Gina Kim, Emmanuelle Tiongson, Leigh Ramos-Platt, Mitchel Seruya

Summary: The study found that spontaneous functional limb recovery in acute flaccid myelitis patients occurred early, within 3 months of the onset of paralysis.

PLASTIC AND RECONSTRUCTIVE SURGERY (2021)

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Review Clinical Neurology

Acute flaccid myelitis a review of the literature

Darina Dinov, Jeffrey R. Donowitz

Summary: Acute flaccid myelitis (AFM) is a rare neurological disorder that predominantly affects children, with no definitive prognostic factors or etiologies found yet. Treatment options are limited with supportive therapy being the most effective.

FRONTIERS IN NEUROLOGY (2022)

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Review Immunology

Unraveling the Mysteries of Acute Flaccid Myelitis: Scientific Opportunities and Priorities for Future Research

Andrea M. Lerner, Amanda J. DeRocco, Linda Yang, Daphne A. Robinson, Robert W. Eisinger, Nicholas D. Bushar, Avindra Nath, Emily Erbelding

Summary: AFM cases have been increasing in the US biennially since 2014, with non-polio enteroviruses like EV-D68 being associated with the syndrome. More research is needed to understand AFM and develop effective therapeutic strategies.

CLINICAL INFECTIOUS DISEASES (2021)

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Article Immunology

Using the Acute Flaccid Paralysis Surveillance System to Identify Cases of Acute Flaccid Myelitis, Australia, 2000-2018

Liz J. Walker, Bruce R. Thorley, Anne Morris, Elizabeth J. Elliott, Nathan Saul, Philip N. Britton

Summary: Since 2012, both the United States and Australia have reported cases of acute flaccid myelitis (AFM) in children. Australia's AFP surveillance system is well-placed to identify future AFM cases, with a low incidence rate.

EMERGING INFECTIOUS DISEASES (2022)

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Article Public, Environmental & Occupational Health

Acute Flaccid Paralysis in Australian Children from 2007 to 2017: clinical spectrum and epidemiology

Junchao Bao, Carlos Nunez, Elizabeth Elliott, Nicole Dinsmore, Jocelynne McRae, Anne Morris, Christopher C. Blyth, Nigel Crawford, Anne Kynaston, Helen Marshall, Bruce Thorley, Peter McIntyre, Philip N. Britton

Summary: The study described the epidemiology and major diagnoses of acute flaccid paralysis (AFP) in Australian children. Guillain-Barre syndrome, transverse myelitis, and acute disseminated encephalomyelitis were identified as the main causes of AFP. The study also observed clustering of cases associated with non-polio enterovirus, highlighting the need for continued surveillance vigilance.

NEUROEPIDEMIOLOGY (2023)

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Article Clinical Neurology

Acute flaccid myelitis and Guillain-Barre syndrome in children: A comparative study with evaluation of diagnostic criteria

Jelte Helfferich, Joyce Roodbol, Marie-Claire de Wit, Oebele F. Brouwer, Bart C. Jacobs

Summary: By comparing clinical features and diagnostic criteria in children with AFM and GBS, we found distinct differences in disease progression, limb weakness presentation, and sensory deficits between AFM and GBS patients. Additionally, spinal cord lesions on MRI were only found in AFM patients.

EUROPEAN JOURNAL OF NEUROLOGY (2022)

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Article Virology

Telaprevir Treatment Reduces Paralysis in a Mouse Model of Enterovirus D68 Acute Flaccid Myelitis

Joshua Frost, Michael J. Rudy, J. Smith Leser, Haozhou Tan, Yanmei Hu, Jun Wang, Penny Clarke, Kenneth L. Tyler

Summary: Recent outbreaks of EV-D68 in 2014, 2016, and 2018 have led to over 600 cases of a paralytic illness called AFM. AFM primarily affects children, lacks an FDA-approved treatment, and shows limited recovery from limb weakness in many patients.

JOURNAL OF VIROLOGY (2023)

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Article Clinical Neurology

Acute Flaccid Myelitis in a Pediatric Patient With Coronavirus Disease 2019

Farah Thabet, Abir Daya, Seifeddine Zayani, Chokri Chouchane, Brahim Tabarki, Slaheddine Chouchane

Summary: The etiology of acute flaccid myelitis (AFM) is still unknown, but a viral link has been suggested. Although SARS-CoV-2-associated AFM has not been reported in children, we describe a three-year-old boy with AFM associated with coronavirus disease 2019 (COVID-19) infection. In the era of COVID-19 pandemic, patients with AFM should be tested for SARS-CoV-2.

PEDIATRIC NEUROLOGY (2023)

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Article Clinical Neurology

Pediatric acute flaccid myelitis: Evaluation of diagnostic criteria and differentiation from other causes of acute flaccid paralysis

Jelte Helfferich, Rinze F. Neuteboom, Marit M. A. de Lange, Kimberley S. M. Benschop, Coretta C. Van Leer-Buter, Adam Meijer, Dewi P. Bakker, Eva de Bie, Hilde M. H. Braakman, Rick Brandsma, Erik H. Niks, Jikke-Mien Niermeijer, Vincent Roelfsema, Niels Schoenmaker, Lilian T. Sie, Hubert G. Niesters, Margreet J. M. te Wierik, Bart C. Jacobs, Oebele F. Brouwer

Summary: Acute flaccid paralysis (AFP) is characterized by rapid limb weakness with low muscle tone. Acute flaccid myelitis (AFM) is a rare cause of AFP that mainly affects young children. This study evaluates the diagnostic criteria for AFM and compares it to other causes of acute weakness in children, aiming to identify distinguishing clinical and diagnostic features.

EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY (2023)

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Review Pathology

Infection-Related Myelopathies

E. Ann Yeh, Carmen Yea, Ari Bitnun

Summary: This article reviews the increasing attention to inflammatory and infectious disorders of the spinal cord in recent years, highlighting the discovery of autoantibody-mediated disorders as well as infection-related myelopathies like acute flaccid myelitis. It outlines a classification system based on association with infection, describes epidemiology, definitions, clinical presentation, and neuroimaging features of myelopathies, and discusses specific myelopathies due to pathogen invasion or post-infectious causes.

ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE (2022)

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Article Rehabilitation

Acute Flaccid Myelitis

William Ide, Michelle Melicosta, Melissa K. Trovato

Summary: AFM is a syndrome of flaccid paralysis affecting primarily children, with no proven effective treatments currently available. The clinical presentation and rehabilitation needs of patients vary significantly, requiring a tailored approach to recovery. Significant knowledge gaps exist in understanding AFM, and a multidisciplinary rehabilitation team is essential to address the wide-ranging impacts of the syndrome on patients.

PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA (2021)

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Three-Year Longitudinal Motor Function and Disability Level of Acute Flaccid Myelitis

Pin Fee Chong, Ryutaro Kira, Hiroyuki Torisu, Sawa Yasumoto, Akihisa Okumura, Harushi Mori, Keiko Tanaka-Taya

Summary: This study summarizes the long-term motor outcome and disability level in pediatric patients with acute flaccid myelitis (AFM) associated with the enterovirus D68 outbreak in 2015. Results showed that some patients demonstrated improvement at the recovery-to-chronic period, and the disability level generally improved at the three-year time point.

PEDIATRIC NEUROLOGY (2021)

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Article Cell Biology

Epidemiological dynamics of enterovirus D68 in the United States and implications for acute flaccid myelitis

Sang Woo Park, Margarita Pons-Salort, Kevin Messacar, Camille Cook, Lindsay Meyers, Jeremy Farrar, Bryan T. Grenfell

Summary: Acute flaccid myelitis (AFM) has emerged in the United States as a rare but serious neurological condition since 2012, with Enterovirus D68 (EV-D68) considered a main causative agent. Strong spatiotemporal association between EV-D68 and AFM was demonstrated, and the impact of the ongoing COVID-19 pandemic likely reduced the sizes of EV-D68 and AFM outbreaks in 2020.

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Increase in Acute Flaccid Myelitis - United States, 2018

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CENTERS DISEASE CONTROL

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