Acute Flaccid Myelitis

Acute Flaccid Myelitis overview and Definition

It is used to describe the patient with suddent onset of flabby limb without the known cause and with the lesions in the gray matter of the spinal cord.it is most common among children.childrens feel difficulty in moving their faces and walking.


Epidemiology: Over 90-95% of the cases is seen in children.

Clinical signs & symptoms

  • Weakness in upper and lower limbs.

  • Flabby face  affecting the muscles of the face leading one side of the face to fall lower on the other.

  • Pain in arm and leg

  • Inability to urinate.

  • Respiratory muscles are affected leading to breathing problems.

  • Slurred speech

  • Fine paraesthesia in the toes or fingers.

Differential Diagnosis

Physical examination and patient history.

Neurological examinations to see check the

mental status(asking general questions to asses the status)

coordination of the movements: your neurologist may ask you to walk in a straight line or closing your eyes and touching your nose with the index finger.

Reflexes: reflexes are tested by tapping your body in a certain way with the soft hammer to rule out the muscle tone.if relexes are normal the mucle movements will be normal on tapping with the hammer.

Sensation: Neurologists touch the legs, arms, and other areas with the instruments such as tunning folk or dull needle and ask you to feel the sensations such as heat, cold, pain.

Autonomic nervous system: this is the system which monitors our visceral organs.neurologists look for pupils in rresponse to the light,blood pressure,pulse rate and heart rate.

An MRI of the spinal cord and Brain: suggestive of lesions in the gray matter.

Testing with cerebrospinal fluid(CSF): used to  analyse cell count and glucose level, protein, antibody produced, viral structures.it shows pleocytosis(increase in white blood cells)

Electromyelograph: measures the electrical activity of muscles and nervesLumbar puncture (CSF): Guillain Barre syndrome, suspicion of viral myelitis

Biochemistry: Creatine Kinase, Potassium, Magnesium, Phosphate

Urine for porpho-bilinogens, toxins: arsenic, lead etc.,


  • The prognosis in children is good when compared to the  adults.

  • Mortality is approximately 3-4% and usually is secondary to autonomic dysfunction and respiratory failure.


Since we don’t know what triggers AFM in a person, there is no specific action to take to prevent AFM. But you can take steps to prevent getting sick from a virus.

You can lower the risk of getting a virus by:

You can lower the risk of spreading a virus by:

  • Cleaning and disinfecting frequently touched surfaces, including toys, mobile devices, and doorknobs.
  • Covering coughs and sneezes with a tissue or upper shirt sleeve, not hands.
  • Staying at home if you or your child is sick.