Why the study?
Worrying waves of life-threatening acute flaccid myelitis consecutive to enterovirus infection have been reported since 2014.
Children with enterovirus-associated acute flaccid myelitis present with either a polio-like phenotype or a brainstem phenotype, with early motor recovery predicting better prognosis.
May aid early risk stratification in enterovirus AFM; hypothesis-generating and requires confirmation in prospective trials.
Acute flaccid myelitis (AFM) is an acute paralysis syndrome defined by a specific inflammation of the anterior horn cells of the spinal cord. From 2014, worrying waves of life-threatening AFM consecutive to enterovirus infection (EV-D68 and EV-A71) have been reported. We describe 10 children displaying an AFM with an EV infection, the treatments performed and the 1 to 3-years follow-up. Two groups of patients were distinguished: 6 children (« polio-like group ») had severe motor disability whereas 4 other children (« brainstem group ») displayed severe brainstem weakness requiring ventilation support. Electrodiagnostic studies (n=8) support the presence of a motor neuronopathy associated to myelitis. The best prognosis factor seems to be the motor recovery after the first 4 weeks of the disease.
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Aubart et al. (2020) studied this question.
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