Syed N Sarmast1, Vykuntaraju K Gowda2, Maaz Ahmed3, Basvaraja Gv4, Jitender Saini5, Asha Benakappa6. 1. Postdoctoral Fellow, Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, India. 2. Associate Professor, Department of Paediatric Neurology, Indira Gandhi Institute of Child Health, Bengaluru, India. 3. Associate Professor, Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, India. 4. Associate Professor, Department of Paediatrics and Paediatrics Critical Care, Indira Gandhi Institute of Child Health, Bengaluru, India. 5. Associate Professor, Department of Neuroradiology, National Institute of Mental Health Sciences, Bengaluru, India. 6. Professor, Department of Paediatrics, Indira Gandhi Institute of Child Health, Bengaluru, India.
Abstract
INTRODUCTION: Acute flaccid myelitis (AFM) is characterized by limb weakness with spinal cord grey matter lesion on imaging or electrodiagnostic evidence of spinal cord motor neuron injury. This Poliomyelitis-like illness is rare in children, and its natural course is not yet well defined. PURPOSE OF THE STUDY: The purpose of the study was to report the clinical presentation, laboratory findings, management and outcome of children with AFM. MATERIALS AND METHODS: This is a prospective case series study. RESULTS: Nine children met the case definition given by CDC. All cases presented with prodromal symptoms followed by acute onset asymmetrical limb weakness. Maximum weakness is reached within 4 days from the day of onset. Cerebrospinal fluid analysis shows that pleocytosis with viral markers for arboviruses and enteroviruses was negative. Electrophysiological study revealed decreased muscle action potential in all. MRI of the spinal cord showed predominantly grey matter involvement. CONCLUSION: AFM should be one of the differential diagnoses in any child presenting with acute flaccid paralysis.
INTRODUCTION: Acute flaccid myelitis (AFM) is characterized by limb weakness with spinal cord grey matter lesion on imaging or electrodiagnostic evidence of spinal cord motor neuron injury. This Poliomyelitis-like illness is rare in children, and its natural course is not yet well defined. PURPOSE OF THE STUDY: The purpose of the study was to report the clinical presentation, laboratory findings, management and outcome of children with AFM. MATERIALS AND METHODS: This is a prospective case series study. RESULTS: Nine children met the case definition given by CDC. All cases presented with prodromal symptoms followed by acute onset asymmetrical limb weakness. Maximum weakness is reached within 4 days from the day of onset. Cerebrospinal fluid analysis shows that pleocytosis with viral markers for arboviruses and enteroviruses was negative. Electrophysiological study revealed decreased muscle action potential in all. MRI of the spinal cord showed predominantly grey matter involvement. CONCLUSION:AFM should be one of the differential diagnoses in any child presenting with acute flaccid paralysis.
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