girl hospitalized with acute flaccid myelitis

Acute flaccid myelitis: What parents should know

We know how alarming it can feel for parents to hear news reports about a medical emergency known as acute flaccid myelitis. This Q&A with CHOC pediatric experts offers answers to your frequently asked questions, including what to do if you suspect your child has acute flaccid myelitis.

What is acute flaccid myelitis?

Acute flaccid myelitis (AFM) is a rare condition that affects the spinal cord, which can lead to muscle weakness. It usually affects children and happens following a fever or cold symptoms.

What causes acute flaccid myelitis?

The cause is not known for sure but experts believe that viruses, including enteroviruses, might cause AFM. Most cases occur between August and November.

AFM is not a new problem, but many people are just learning about it in news reports because of recent outbreaks.

AFM is still very rare, with fewer than one in 1 million people per year being diagnoses in the U.S. It usually affects children.

What are the signs and symptoms of acute flaccid myelitis?

A child with AFM usually has progressive weakness in the arms and legs that may be rapid over hours to days. Their face may also be affected. Other symptoms of AFM include:
~ Drooping eyelids
~ Pain or numbness in one or more limbs
~ Difficulty walking
~ Headache
~ Back or neck pain
~ Difficulty talking or swallowing
~ Neck or facial weakness

Most children with AFM will have a fever or respiratory illness about six days before weakness occurs. For this reason, AFM has been associated with certain types of viruses, and specifically one called enterovirus D68.

What should I do if I think my child has acute flaccid myelitis?

If you or your child have any symptoms of AFM, get medical care right away. With AFM, a patient’s health can decline quickly, resulting in paralysis or the need for a ventilator. AFM can sometimes lead to permanently disability.

It is safe to seek the emergency and preventive care you and your children need despite the ongoing COVID-19 pandemic.

When AFM is caught early, doctors can hospitalize patients and provide optimal medical management and rehabilitation.

What is the treatment for AFM?

If doctors suspect your child has AFM, they will be hospitalized and cared for by a team of multidisciplinary specialists which may include primary care, neurology, infectious disease, physical therapy and occupational therapy. Doctors will review your child’s medical history, perform a physical exam and use an MRI to review your child’s spinal cord.

Scientists are still studying possible treatments for AFM. Possible treatments that may be used include:
~ Corticosteroids, used to treat inflammation
~ Intravenous immunoglobulin, used to treat immune disorders
~ Plasmapheresis, used to remove antibodies from the blood

Physical rehabilitation could help improve long-term outcomes. Some patients may receive nerve transfer surgery to repair nerve injuries.

Talk to your child’s doctor about specific questions you have for their care.

Can you prevent acute flaccid myelitis?

Viruses might cause AFM, so you can avoid spreading germs by:
~ Washing your hands well and often
~ Keeping up to date on vaccinations
~ Preventing mosquito bites
Keeping sick children home from school

Is acute flaccid myelitis contagious?

No, AFM is not contagious.

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