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Acute Flaccid Myelitis
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Acute flaccid myelitis (AFM)
              • Synonyms

                • Acute flaccid paralysis
                • Poliomyelitis-like paralytic syndrome

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Kramer R et al: Acute flaccid myelitis caused by enterovirus D68: case definitions for use in clinical practice. Eur J Paediatr Neurol. ePub, 2019
                                            2. Messacar K et al: Enterovirus D68-associated acute flaccid myelitis: rising to the clinical and research challenges. JAMA. ePub, 2019
                                            3. Bitnun A et al: Acute flaccid paralysis and enteroviral infections. Curr Infect Dis Rep. 20(9):34, 2018
                                            4. Chong PF et al: Clinical features of acute flaccid myelitis temporally associated with an enterovirus D68 outbreak: results of a nationwide survey of acute flaccid paralysis in Japan, August-December 2015. Clin Infect Dis. 66(5):653-64, 2018
                                            5. Dyda A et al: The association between acute flaccid myelitis (AFM) and Enterovirus D68 (EV-D68) - what is the evidence for causation? Euro Surveill. 23(3), 2018
                                            6. Messacar K et al: Enterovirus D68 and acute flaccid myelitis-evaluating the evidence for causality. Lancet Infect Dis. 18(8):e239-47, 2018
                                            7. Andersen EW et al: Acute flaccid myelitis in childhood: a retrospective cohort study. Eur J Neurol. 24(8):1077-83, 2017
                                            8. Ben Achour N et al: Comment on 'Acute flaccid myelitis in childhood: a retrospective cohort study'. Eur J Neurol. 24(11):e81-2, 2017
                                            9. Bonwitt J et al: Acute flaccid myelitis among children - Washington, September-November 2016. MMWR Morb Mortal Wkly Rep. 66(31):826-9, 2017
                                            10. Esposito S et al: Acute flaccid myelitis associated with enterovirus-D68 infection in an otherwise healthy child. Virol J. 14(1):4, 2017
                                            11. Hopkins SE: Acute flaccid myelitis: Etiologic challenges, diagnostic and management considerations. Curr Treat Options Neurol. 19(12):48, 2017
                                            12. Makhani N et al: Abnormal fluid-attenuated inversion recovery signal in the internal capsule: a novel brain magnetic resonance imaging finding in a child with acute flaccid myelitis. Pediatr Neurol. 73:108-109, 2017
                                            13. Martin JA et al: Outcomes of Colorado children with acute flaccid myelitis at 1 year. Neurology. 89(2):129-37, 2017
                                            14. McCoy DB et al: MRI atlas-based measurement of spinal cord injury predicts outcome in acute flaccid myelitis. AJNR Am J Neuroradiol. 38(2):410-7, 2017
                                            15. Ruggieri V et al: Enterovirus D68 infection in a cluster of children with acute flaccid myelitis, Buenos Aires, Argentina, 2016. Eur J Paediatr Neurol. 21(6):884-90, 2017
                                            16. Wiznitzer M et al: Acute flaccid myelitis and enterovirus D68: déjà vu all over again. Neurology. 89(2):112-3, 2017
                                            17. Yoder JA et al: Pediatric acute flaccid paralysis: enterovirus D68-associated anterior myelitis. J Emerg Med. 53(1):e19-e23, 2017
                                            18. Aliabadi N et al: Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerg Infect Dis. 22(8):1387-94, 2016
                                            19. Messacar K et al: Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol. 80(3):326-38, 2016
                                            20. Nelson GR et al: Recognition and management of acute flaccid myelitis in children. Pediatr Neurol. 55:17-21, 2016
                                            21. Sejvar JJ et al: Acute flaccid myelitis in the United States, August-December 2014: Results of Nationwide Surveillance. Clin Infect Dis. 63(6):737-45, 2016
                                            22. Maloney JA et al: MRI Findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. AJNR Am J Neuroradiol. ePub, 2014
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Acute flaccid myelitis (AFM)
                                                        • Synonyms

                                                          • Acute flaccid paralysis
                                                          • Poliomyelitis-like paralytic syndrome

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Kramer R et al: Acute flaccid myelitis caused by enterovirus D68: case definitions for use in clinical practice. Eur J Paediatr Neurol. ePub, 2019
                                                                                      2. Messacar K et al: Enterovirus D68-associated acute flaccid myelitis: rising to the clinical and research challenges. JAMA. ePub, 2019
                                                                                      3. Bitnun A et al: Acute flaccid paralysis and enteroviral infections. Curr Infect Dis Rep. 20(9):34, 2018
                                                                                      4. Chong PF et al: Clinical features of acute flaccid myelitis temporally associated with an enterovirus D68 outbreak: results of a nationwide survey of acute flaccid paralysis in Japan, August-December 2015. Clin Infect Dis. 66(5):653-64, 2018
                                                                                      5. Dyda A et al: The association between acute flaccid myelitis (AFM) and Enterovirus D68 (EV-D68) - what is the evidence for causation? Euro Surveill. 23(3), 2018
                                                                                      6. Messacar K et al: Enterovirus D68 and acute flaccid myelitis-evaluating the evidence for causality. Lancet Infect Dis. 18(8):e239-47, 2018
                                                                                      7. Andersen EW et al: Acute flaccid myelitis in childhood: a retrospective cohort study. Eur J Neurol. 24(8):1077-83, 2017
                                                                                      8. Ben Achour N et al: Comment on 'Acute flaccid myelitis in childhood: a retrospective cohort study'. Eur J Neurol. 24(11):e81-2, 2017
                                                                                      9. Bonwitt J et al: Acute flaccid myelitis among children - Washington, September-November 2016. MMWR Morb Mortal Wkly Rep. 66(31):826-9, 2017
                                                                                      10. Esposito S et al: Acute flaccid myelitis associated with enterovirus-D68 infection in an otherwise healthy child. Virol J. 14(1):4, 2017
                                                                                      11. Hopkins SE: Acute flaccid myelitis: Etiologic challenges, diagnostic and management considerations. Curr Treat Options Neurol. 19(12):48, 2017
                                                                                      12. Makhani N et al: Abnormal fluid-attenuated inversion recovery signal in the internal capsule: a novel brain magnetic resonance imaging finding in a child with acute flaccid myelitis. Pediatr Neurol. 73:108-109, 2017
                                                                                      13. Martin JA et al: Outcomes of Colorado children with acute flaccid myelitis at 1 year. Neurology. 89(2):129-37, 2017
                                                                                      14. McCoy DB et al: MRI atlas-based measurement of spinal cord injury predicts outcome in acute flaccid myelitis. AJNR Am J Neuroradiol. 38(2):410-7, 2017
                                                                                      15. Ruggieri V et al: Enterovirus D68 infection in a cluster of children with acute flaccid myelitis, Buenos Aires, Argentina, 2016. Eur J Paediatr Neurol. 21(6):884-90, 2017
                                                                                      16. Wiznitzer M et al: Acute flaccid myelitis and enterovirus D68: déjà vu all over again. Neurology. 89(2):112-3, 2017
                                                                                      17. Yoder JA et al: Pediatric acute flaccid paralysis: enterovirus D68-associated anterior myelitis. J Emerg Med. 53(1):e19-e23, 2017
                                                                                      18. Aliabadi N et al: Enterovirus D68 infection in children with acute flaccid myelitis, Colorado, USA, 2014. Emerg Infect Dis. 22(8):1387-94, 2016
                                                                                      19. Messacar K et al: Acute flaccid myelitis: a clinical review of US cases 2012-2015. Ann Neurol. 80(3):326-38, 2016
                                                                                      20. Nelson GR et al: Recognition and management of acute flaccid myelitis in children. Pediatr Neurol. 55:17-21, 2016
                                                                                      21. Sejvar JJ et al: Acute flaccid myelitis in the United States, August-December 2014: Results of Nationwide Surveillance. Clin Infect Dis. 63(6):737-45, 2016
                                                                                      22. Maloney JA et al: MRI Findings in children with acute flaccid paralysis and cranial nerve dysfunction occurring during the 2014 enterovirus D68 outbreak. AJNR Am J Neuroradiol. ePub, 2014