Acute Flaccid Myelitis: Etiologic Challenges, Diagnostic and Management Considerations
العنوان: | Acute Flaccid Myelitis: Etiologic Challenges, Diagnostic and Management Considerations |
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المؤلفون: | Sarah E. Hopkins |
المصدر: | Current Treatment Options in Neurology. 19 |
بيانات النشر: | Springer Science and Business Media LLC, 2017. |
سنة النشر: | 2017 |
مصطلحات موضوعية: | Occupational therapy, medicine.medical_specialty, Rehabilitation, Neurology, Flaccid paralysis, business.industry, medicine.medical_treatment, medicine.disease, Transverse myelitis, Acute flaccid myelitis, Poliomyelitis, 03 medical and health sciences, 0302 clinical medicine, medicine, Etiology, 030212 general & internal medicine, Neurology (clinical), medicine.symptom, Intensive care medicine, business, 030217 neurology & neurosurgery |
الوصف: | Purpose of review Acute flaccid myelitis is a polio-like illness defined by the acute onset of flaccid paralysis in the setting spinal MRI demonstrating a longitudinal lesion in the gray matter of the cord. This paper aims to review the current state of knowledge and key clinical points for the diagnosis and management of acute flaccid myelitis. Recent findings There were clusters of AFM noted in California and Colorado in 2014, with additional cases across the USA that year, and another spike in cases in 2016. Patients have been managed with classic treatments for transverse myelitis, but in general without benefit, although some colleagues have noted anecdotal improvement in individual patients. Our current practice at the Children’s Hospital of Philadelphia is to initiate therapy with intravenous immunoglobulin (IVIG) upon recognition of acute flaccid myelitis in hopes of boosting humoral immunity, and to provide an emphasis on rehabilitation services, including physical and occupational therapy. There is some data that suggests a connection to the virus enterovirus D68 (EV D68), but there has been no definitive link. Publications regarding longer-term outcomes in these patients are early in development and, thus far, only provide data for 6 to 12 months from onset. Summary AFM is a serious illness with long-term consequences, and we have much to learn. Key areas in need of further investigation involve etiology, host susceptibilities, treatment options, and long-term outcome. Individual clinicians can assist in these efforts by the prompt reporting of cases of AFM to the US Centers for Disease Control and Prevention. |
تدمد: | 1534-3138 1092-8480 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9111f5c6ba2ef1f50e08434d41846d0f https://doi.org/10.1007/s11940-017-0480-3 |
حقوق: | CLOSED |
رقم الأكسشن: | edsair.doi.dedup.....9111f5c6ba2ef1f50e08434d41846d0f |
قاعدة البيانات: | OpenAIRE |
تدمد: | 15343138 10928480 |
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