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Acute flaccid myelitis

MedGen UID:
927532
•Concept ID:
C4290000
•
Disease or Syndrome
Synonyms: acute flaccid myelitis; AFM syndrome
SNOMED CT: Acute flaccid myelitis (897031002)
 
Monarch Initiative: MONDO:0100115
Orphanet: ORPHA623801

Definition

An acute onset of focal limb weakness that is associated mainly with gray matter abnormalities or CSF pleocytosis, but which is without an apparent cause. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAcute flaccid myelitis

Professional guidelines

PubMed

Acute flaccid myelitis: Consensus diagnostic criteria is helpful but careful evaluation of disease course is as important.
Lee VWM, Lim M
Eur J Paediatr Neurol 2023 May;44:A3-A4. Epub 2023 May 4 doi: 10.1016/j.ejpn.2023.05.002. PMID: 37173270
Current perspectives on the diagnosis and management of acute transverse myelitis.
Tisavipat N, Flanagan EP
Expert Rev Neurother 2023 Apr;23(4):389-411. Epub 2023 Apr 7 doi: 10.1080/14737175.2023.2195095. PMID: 37026545
Acute flaccid myelitis: cause, diagnosis, and management.
Murphy OC, Messacar K, Benson L, Bove R, Carpenter JL, Crawford T, Dean J, DeBiasi R, Desai J, Elrick MJ, Farias-Moeller R, Gombolay GY, Greenberg B, Harmelink M, Hong S, Hopkins SE, Oleszek J, Otten C, Sadowsky CL, Schreiner TL, Thakur KT, Van Haren K, Carballo CM, Chong PF, Fall A, Gowda VK, Helfferich J, Kira R, Lim M, Lopez EL, Wells EM, Yeh EA, Pardo CA; AFM working group
Lancet 2021 Jan 23;397(10271):334-346. Epub 2020 Dec 23 doi: 10.1016/S0140-6736(20)32723-9. PMID: 33357469Free PMC Article

Recent clinical studies

Etiology

Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis: A Meta-analysis.
Nosadini M, Eyre M, Molteni E, Thomas T, Irani SR, Dalmau J, Dale RC, Lim M; International NMDAR Antibody Encephalitis Consensus Group, Anlar B, Armangue T, Benseler S, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sartori S, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK
JAMA Neurol 2021 Nov 1;78(11):1333-1344. doi: 10.1001/jamaneurol.2021.3188. PMID: 34542573Free PMC Article
Acute flaccid myelitis: cause, diagnosis, and management.
Murphy OC, Messacar K, Benson L, Bove R, Carpenter JL, Crawford T, Dean J, DeBiasi R, Desai J, Elrick MJ, Farias-Moeller R, Gombolay GY, Greenberg B, Harmelink M, Hong S, Hopkins SE, Oleszek J, Otten C, Sadowsky CL, Schreiner TL, Thakur KT, Van Haren K, Carballo CM, Chong PF, Fall A, Gowda VK, Helfferich J, Kira R, Lim M, Lopez EL, Wells EM, Yeh EA, Pardo CA; AFM working group
Lancet 2021 Jan 23;397(10271):334-346. Epub 2020 Dec 23 doi: 10.1016/S0140-6736(20)32723-9. PMID: 33357469Free PMC Article
Acute infectious myelopathies.
Isada CM, Miller R
Curr Opin Infect Dis 2020 Jun;33(3):251-258. doi: 10.1097/QCO.0000000000000650. PMID: 32332224
Acute Flaccid Myelitis.
Cartwright CC, Wessol JL
J Neurosci Nurs 2019 Aug;51(4):190-192. doi: 10.1097/JNN.0000000000000447. PMID: 31180940
Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody.
Dubey D, Pittock SJ, Krecke KN, Morris PP, Sechi E, Zalewski NL, Weinshenker BG, Shosha E, Lucchinetti CF, Fryer JP, Lopez-Chiriboga AS, Chen JC, Jitprapaikulsan J, McKeon A, Gadoth A, Keegan BM, Tillema JM, Naddaf E, Patterson MC, Messacar K, Tyler KL, Flanagan EP
JAMA Neurol 2019 Mar 1;76(3):301-309. doi: 10.1001/jamaneurol.2018.4053. PMID: 30575890Free PMC Article

Diagnosis

Current perspectives on the diagnosis and management of acute transverse myelitis.
Tisavipat N, Flanagan EP
Expert Rev Neurother 2023 Apr;23(4):389-411. Epub 2023 Apr 7 doi: 10.1080/14737175.2023.2195095. PMID: 37026545
Acute Flaccid Myelitis.
Ide W, Melicosta M, Trovato MK
Phys Med Rehabil Clin N Am 2021 Aug;32(3):477-491. Epub 2021 May 20 doi: 10.1016/j.pmr.2021.02.004. PMID: 34175008
Neuroinfectious Disease Emergencies.
McEntire CRS, Anand P, Cervantes-Arslanian AM
Neurol Clin 2021 May;39(2):565-588. Epub 2021 Mar 31 doi: 10.1016/j.ncl.2021.02.003. PMID: 33896533
Acute flaccid myelitis: cause, diagnosis, and management.
Murphy OC, Messacar K, Benson L, Bove R, Carpenter JL, Crawford T, Dean J, DeBiasi R, Desai J, Elrick MJ, Farias-Moeller R, Gombolay GY, Greenberg B, Harmelink M, Hong S, Hopkins SE, Oleszek J, Otten C, Sadowsky CL, Schreiner TL, Thakur KT, Van Haren K, Carballo CM, Chong PF, Fall A, Gowda VK, Helfferich J, Kira R, Lim M, Lopez EL, Wells EM, Yeh EA, Pardo CA; AFM working group
Lancet 2021 Jan 23;397(10271):334-346. Epub 2020 Dec 23 doi: 10.1016/S0140-6736(20)32723-9. PMID: 33357469Free PMC Article
Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody.
Dubey D, Pittock SJ, Krecke KN, Morris PP, Sechi E, Zalewski NL, Weinshenker BG, Shosha E, Lucchinetti CF, Fryer JP, Lopez-Chiriboga AS, Chen JC, Jitprapaikulsan J, McKeon A, Gadoth A, Keegan BM, Tillema JM, Naddaf E, Patterson MC, Messacar K, Tyler KL, Flanagan EP
JAMA Neurol 2019 Mar 1;76(3):301-309. doi: 10.1001/jamaneurol.2018.4053. PMID: 30575890Free PMC Article

Therapy

Acute Flaccid Myelitis: Review of Clinical Features, Diagnosis, and Management with Nerve Transfers.
Kozlowski J, Linzey JR, Muhlestein WE, Smith BW, Chang KW, Yang LJ
Plast Reconstr Surg 2023 Jan 1;151(1):85e-98e. Epub 2022 Oct 11 doi: 10.1097/PRS.0000000000009788. PMID: 36219869
Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis: A Meta-analysis.
Nosadini M, Eyre M, Molteni E, Thomas T, Irani SR, Dalmau J, Dale RC, Lim M; International NMDAR Antibody Encephalitis Consensus Group, Anlar B, Armangue T, Benseler S, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sartori S, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK
JAMA Neurol 2021 Nov 1;78(11):1333-1344. doi: 10.1001/jamaneurol.2021.3188. PMID: 34542573Free PMC Article
Enterovirus D68 and acute flaccid myelitis: do we need a measles mentality?
Tetro JA
Microbes Infect 2019 Aug-Sep;21(7):271-272. Epub 2019 Mar 4 doi: 10.1016/j.micinf.2019.02.006. PMID: 30844444
Current Understanding of Humoral Immunity to Enterovirus D68.
Vogt MR, Crowe JE Jr
J Pediatric Infect Dis Soc 2018 Dec 26;7(suppl_2):S49-S53. doi: 10.1093/jpids/piy124. PMID: 30590621
Acute flaccid myelitis.
Gill PJ, Bitnun A, Yeh EA
CMAJ 2018 Dec 3;190(48):E1418. doi: 10.1503/cmaj.181442. PMID: 30510047Free PMC Article

Prognosis

Current perspectives on the diagnosis and management of acute transverse myelitis.
Tisavipat N, Flanagan EP
Expert Rev Neurother 2023 Apr;23(4):389-411. Epub 2023 Apr 7 doi: 10.1080/14737175.2023.2195095. PMID: 37026545
Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis: A Meta-analysis.
Nosadini M, Eyre M, Molteni E, Thomas T, Irani SR, Dalmau J, Dale RC, Lim M; International NMDAR Antibody Encephalitis Consensus Group, Anlar B, Armangue T, Benseler S, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sartori S, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK
JAMA Neurol 2021 Nov 1;78(11):1333-1344. doi: 10.1001/jamaneurol.2021.3188. PMID: 34542573Free PMC Article
Acute flaccid myelitis: cause, diagnosis, and management.
Murphy OC, Messacar K, Benson L, Bove R, Carpenter JL, Crawford T, Dean J, DeBiasi R, Desai J, Elrick MJ, Farias-Moeller R, Gombolay GY, Greenberg B, Harmelink M, Hong S, Hopkins SE, Oleszek J, Otten C, Sadowsky CL, Schreiner TL, Thakur KT, Van Haren K, Carballo CM, Chong PF, Fall A, Gowda VK, Helfferich J, Kira R, Lim M, Lopez EL, Wells EM, Yeh EA, Pardo CA; AFM working group
Lancet 2021 Jan 23;397(10271):334-346. Epub 2020 Dec 23 doi: 10.1016/S0140-6736(20)32723-9. PMID: 33357469Free PMC Article
Enterovirus infection and acute flaccid myelitis.
Uprety P, Graf EH
Curr Opin Virol 2020 Feb;40:55-60. Epub 2020 Jul 22 doi: 10.1016/j.coviro.2020.06.006. PMID: 32711392
Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody.
Dubey D, Pittock SJ, Krecke KN, Morris PP, Sechi E, Zalewski NL, Weinshenker BG, Shosha E, Lucchinetti CF, Fryer JP, Lopez-Chiriboga AS, Chen JC, Jitprapaikulsan J, McKeon A, Gadoth A, Keegan BM, Tillema JM, Naddaf E, Patterson MC, Messacar K, Tyler KL, Flanagan EP
JAMA Neurol 2019 Mar 1;76(3):301-309. doi: 10.1001/jamaneurol.2018.4053. PMID: 30575890Free PMC Article

Clinical prediction guides

In vitro and in vivo models for the study of EV-D68 infection.
Hooi YT, Balasubramaniam VRMT
Pathology 2023 Dec;55(7):907-916. Epub 2023 Sep 25 doi: 10.1016/j.pathol.2023.08.007. PMID: 37852802
Current perspectives on the diagnosis and management of acute transverse myelitis.
Tisavipat N, Flanagan EP
Expert Rev Neurother 2023 Apr;23(4):389-411. Epub 2023 Apr 7 doi: 10.1080/14737175.2023.2195095. PMID: 37026545
Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis: A Meta-analysis.
Nosadini M, Eyre M, Molteni E, Thomas T, Irani SR, Dalmau J, Dale RC, Lim M; International NMDAR Antibody Encephalitis Consensus Group, Anlar B, Armangue T, Benseler S, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sartori S, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK
JAMA Neurol 2021 Nov 1;78(11):1333-1344. doi: 10.1001/jamaneurol.2021.3188. PMID: 34542573Free PMC Article
Update on acute flaccid myelitis: recognition, reporting, aetiology and outcomes.
Hardy D, Hopkins S
Arch Dis Child 2020 Sep;105(9):842-847. Epub 2020 Feb 10 doi: 10.1136/archdischild-2019-316817. PMID: 32041735
Clinical, Radiologic, and Prognostic Features of Myelitis Associated With Myelin Oligodendrocyte Glycoprotein Autoantibody.
Dubey D, Pittock SJ, Krecke KN, Morris PP, Sechi E, Zalewski NL, Weinshenker BG, Shosha E, Lucchinetti CF, Fryer JP, Lopez-Chiriboga AS, Chen JC, Jitprapaikulsan J, McKeon A, Gadoth A, Keegan BM, Tillema JM, Naddaf E, Patterson MC, Messacar K, Tyler KL, Flanagan EP
JAMA Neurol 2019 Mar 1;76(3):301-309. doi: 10.1001/jamaneurol.2018.4053. PMID: 30575890Free PMC Article

Recent systematic reviews

Acute Flaccid Myelitis: Review of Clinical Features, Diagnosis, and Management with Nerve Transfers.
Kozlowski J, Linzey JR, Muhlestein WE, Smith BW, Chang KW, Yang LJ
Plast Reconstr Surg 2023 Jan 1;151(1):85e-98e. Epub 2022 Oct 11 doi: 10.1097/PRS.0000000000009788. PMID: 36219869
Neurosarcoidosis in children: A systematic review and summary of cases, imaging and management.
Young M, Goldman-Yassen A, Anderson M, Thakral A, Dutt M, Wolf D, Morris M, Gombolay G
J Neuroimmunol 2022 Oct 15;371:577938. Epub 2022 Aug 1 doi: 10.1016/j.jneuroim.2022.577938. PMID: 35944453Free PMC Article
Immune responses to SARS-CoV-2 vaccination in multiple sclerosis: a systematic review/meta-analysis.
Gombolay GY, Dutt M, Tyor W
Ann Clin Transl Neurol 2022 Aug;9(8):1321-1331. Epub 2022 Jul 19 doi: 10.1002/acn3.51628. PMID: 35852423Free PMC Article
Global prevalence and case fatality rate of Enterovirus D68 infections, a systematic review and meta-analysis.
Fall A, Kenmoe S, Ebogo-Belobo JT, Mbaga DS, Bowo-Ngandji A, Foe-Essomba JR, Tchatchouang S, Amougou Atsama M, Yéngué JF, Kenfack-Momo R, Feudjio AF, Nka AD, Mbongue Mikangue CA, Taya-Fokou JB, Magoudjou-Pekam JN, Noura EA, Zemnou-Tepap C, Meta-Djomsi D, Maïdadi-Foudi M, Kame-Ngasse GI, Nyebe I, Djukouo LG, Kengne Gounmadje L, Tchami Ngongang D, Oyono MG, Demeni Emoh CP, Tazokong HR, Mahamat G, Kengne-Ndé C, Sadeuh-Mba SA, Dia N, La Rosa G, Ndip L, Njouom R
PLoS Negl Trop Dis 2022 Feb;16(2):e0010073. Epub 2022 Feb 8 doi: 10.1371/journal.pntd.0010073. PMID: 35134062Free PMC Article
Upper extremity nerve transfers for acute flaccid myelitis: a systematic literature review.
Texakalidis P, Xenos D, Murthy NK, Karras CL, Trybula SJ, Behbahani M, DeCuypere MG, Lam SK, Alden TD
Childs Nerv Syst 2022 Mar;38(3):521-526. Epub 2022 Jan 4 doi: 10.1007/s00381-021-05419-x. PMID: 34982205

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