Acute Flaccid Myelitis in Children

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Acute Flaccid Myelitis in Children​

Each year, children in the United States are diagnosed with acute flaccid myelitis (AFM), a rare but serious condition. It affects the nervous system, specifically the area of spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. Symptoms include:

  • Sudden onset of arm or leg weakness and loss of muscle tone and reflexes,
  • Facial droop/weakness,
  • Difficulty moving the eyes,
  • Drooping eyelids, or
  • Difficulty with swallowing or slurred speech.

CDC continues to investigate the possible causes of AFM related to viral infections, environmental toxins, and genetic disorders.

From August 2014 through September 2018, the Centers for Disease Control and Prevention (CDC) received information on a total of 362 cases of AFM across the US; most of the cases have been in children. Review of case information and assignment of final case classification for all suspected AFM cases is done by experts in national AFM surveillance.

A patient must meet the l criteria below to be considered either a confirmed or probable case of AFM:

Confirmed Case
To be considered a confirmed case, a patient must meet the following criteria:

  • Acute flaccid weakness of one or more limbs, AND
  • Confirmatory laboratory evidence: MRI showing spinal cord lesion largely restricted to gray matter and spanning one or more spinal segments.

Probable Case
To be considered a probable case, a patient must meet the following criteria:

  • Acute flaccid weakness of one or more limbs, AND
  • Supportive laboratory evidence: cerebrospinal fluid (CSF) showing pleocytosis (white blood cell count >5 cells/mm).

Suspect a Patient May Have AFM?

Urgent questions may be directed to the CDC Emergency Operations Center (770-488-7100). Non-urgent questions can be emailed to the AFM team at limbweakness@cdc.gov.

Additional Resources

AAP Publications

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