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. AFM 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.

The Centers for Disease Control and Prevention (CDC) continues to investigate the possible causes of AFM related to viral infections, environmental toxins, and genetic disorders.

From August 2014 through January 2019, the CDC received information on a total of 522 confirmed 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 are managed by experts in national AFM surveillance.

A patient must meet specific criteria to be considered 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 that spans 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/mm3).

Suspect a Patient May Have AFM?

The CDC offers the following resources for clinicians:

Urgent questions may be directed to the CDC Emergency Operations Center (770-488-7100). Physicians should identify themselves as such and indicate when they are calling specific to a pediatric patient. Non-urgent questions can be emailed to the AFM team

Additional Resources

Materials for Patients

Recent AAP Publications

For a full list of AAP publications, contact us

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