Acute flaccid myelitis: early recognition is the key

Archivist was reminded of acute flaccid myelitis (AFM) when he was involved with a few cases following an enterovirus D68 mini outbreak a few years ago. It is a rare diagnosis in UK. Part of the role of the general paediatrician is to be aware of these rarities and diagnose promptly. In a small case series, reported by Matesanz S et al. [J Pediatr 2019 Aug 8. pii: S0022-3476(19)30849-2. doi: 10.1016/j.jpeds.2019.07.015] the diagnostic features were highlighted. Acute flaccid myelitis (AFM) is defined as the acute onset of focal limb weakness with corresponding spinal cord grey matter-specific abnormalities spanning one or more spinal segments on MRI, sometimes with associated brainstem and posterior fossa abnormalities. Weakness typically begins in the setting of a recent or current respiratory and/or febrile illness and may be rapidly progressive. The diagnosis is often delayed and the evidence base for treatment is poor. This was a chart...

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