Key result
Among 18 children with acute flaccid myelitis, all patients retained residual paresis of varying severity despite therapy, and a clear disease seasonality from July to November was observed.
Observational (n=18)
Yes
Acute flaccid myelitis in children presents with a distinct seasonal pattern and results in persistent paresis, highlighting the need for expanded laboratory investigation to identify the etiology.
Russian AFM cases show no identifiable pathogen and incomplete recovery; leaves open value of expanded lab algorithms for etiology.
Acute flaccid myelitis is a syndrome characterized as the development of acute flaccid paralysis of one or more limbs due to lesions of the anterior horns of the spinal cord, which occurs against the background of a viral infection. More than 300 acute flaccid paralysis cases are registered in the Russian Federation annually, most of them are of a non-infectious etiology. In some cases, patients develop a complex of symptoms similar to poliomyelitis, but without isolation of polioviruses from stool samples. Clinical characteristics of such cases include acute onset, fever, persistent peripheral asymmetric paresis/paralysis of predominantly proximal parts of the limbs, and absence of pathological reflexes, pelvic disturbances, or pyramidal symptoms. In literature, such complex of symptoms is referred as acute flaccid myelitis. We provide an analysis of 18 cases of acute flaccid myelitis detected in the Russian Federation in the period from 2015 to 2019. A clear seasonality of the disease from July to November was noted. Studies of faecal samples, cerebrospinal fluid and blood samples did not reveal the pathogen. In all patients, regardless of therapy, there was a positive trend, but complete recovery was not achieved: paresis of varying severity persisted, mainly in the proximal extremities Therefore, acute flaccid myelitis cases as acute flaccid paralysis cases of unknown etiology require an additional observation and an expanded algorithm of laboratory investigation aimed to finding a possible pathogen.
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Shakaryan et al. (2023) conducted an observational in Acute flaccid myelitis (n=18). Acute flaccid myelitis was evaluated on Residual paralysis and muscle wasting. Among 18 children with acute flaccid myelitis, all patients retained residual paresis of varying severity despite therapy, and a clear disease seasonality from July to November was observed.
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