Pathogenesis Acute Flaccid Myelitis (AFM)

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By nclexnursing

Acute flaccid myelitis (AFM) is a condition that affects the nervous system. It’s a rare occurrence, but it’s serious. Gray matter, a part of the spinal cord, is affected. The muscles and reflexes in the body may become weak as a result of this.

Some individuals refer to AFM as a “polio-like” sickness because of these symptoms. People with AFM have been tested for poliovirus since 2014, and none of them tested positive.


Many of the AFM cases reported in 2014 were timed to coincide with enterovirus D68-related respiratory disease outbreaks. In the vast majority of cases, testing has revealed no enterovirus D68 or other viral infections in the cerebrospinal fluid. 35 Several factors point to a link between AFM and enterovirus D68 infections: 36,37

  • The most prevalent virus found in respiratory samples from children with AFM was enterovirus D68.
  • AFM incidences were more infrequent when enterovirus D68 was not circulating in 2015, and clustered during periods of enterovirus D68 circulation from 2014 to 2016.
  • In a mouse model of paralytic myelitis, contemporary enterovirus D68 strains cause paralysis.
  • Despite intensive pathogen-specific testing, the CDC emphasizes that the etiology of AFM has not been determined in the majority of cases.

Acute flaccid myelitis (AFM) is caused by a variety of factors.

Viruses, notable enteroviruses, are thought to play a role in AFM, according to researchers. Before developing AFM, the majority of participants experienced a moderate respiratory illness or fever (similar to what you’d get from a viral infection).

Acute flaccid myelitis (AFM) affects people of all ages.

AFM can affect anyone, however, the majority of instances (more than 90%) have occurred in young children.

Acute flaccid myelitis (AFM) has a variety of symptoms.

The majority of persons with AFM will develop symptoms all of a sudden.

  • Weakness in one either arms or legs
  • Muscle tone and reflexes are deteriorating.

Other signs and symptoms that some people experience include:

  • Drooping/weakness of the face
  • Have difficulty moving your eyes
  • Eyelids that droop
  • Having difficulty swallowing
  • Speech slurred
  • Arms, legs, back, or neck discomfort

AFM can sometimes weaken the muscles required for breathing. This can result in respiratory failure, which is a life-threatening condition. If you have respiratory failure, you may require the assistance of a ventilator (breathing machine).

If you or your kid gets any of these symptoms, seek medical attention immediately.

Acute flaccid myelitis (AFM) is diagnosed in one of two ways.

Many of the symptoms of AFM are similar to those of other neurologic illnesses such as transverse myelitis and Guillain-Barre syndrome. It can be difficult to diagnose as a result of this. A doctor can use a variety of tools to make a diagnosis, including:

  • A neurologic examination, which includes searching for areas of weakness, poor muscle tone, and slowed reflexes.
  • A magnetic resonance imaging (MRI) imaging of the spinal cord and brain
  • Cerebrospinal fluid studies in the lab (the fluid around the brain and spinal cord)
  • Electromyography (EMG) and nerve conduction tests. These tests examine nerve speed as well as muscle reaction to neural impulses.

The tests should be performed as soon as feasible after the symptoms appear.

What are the symptoms of acute flaccid myelitis (AFM) and how may it be treated?

AFM does not have a specific treatment. A neurologist (a specialist who specializes in treating diseases of the brain and spinal cord) may propose therapy for specific symptoms. Physical and/or occupational therapy, for example, can help with arm or limb weakness. The long-term effects of patients with AFM are unknown to researchers.

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Is it possible to prevent acute flaccid myelitis (AFM)?

Because viruses are likely to play a role in AFM, you should take precautions to avoid contracting or spreading viral infections.

  • Handwashing with soap and water on a constant schedule
  • Avoid touching your face with your hands that haven’t been washed.
  • Keeping a safe distance from sick individuals
  • Cleaning and cleaning commonly touched surfaces, such as toys
  • Coughs and sneezes should be covered with a tissue or upper shirt sleeve, not your hands.
  • When you’re sick, you should stay at home.

Before developing AFM, the majority of patients (more than 90%) had a minor respiratory illness or fever that was consistent with a viral infection. Enterovirus infections are frequent, especially in youngsters, and most people recover. It’s unclear why just a tiny percentage of people get AFM while the majority recover. This is presently being looked into.
All stool specimens received from AFM patients proved negative for poliovirus, indicating that the disease is not caused by the virus.