Nerve transfers for acute flaccid myelitis: a case series.

Abstract

Acute flaccid myelitis (AFM) syndrome consists of loss of lower motor neurons following a viral infection, with preserved sensory function. It usually affects the upper limbs asymmetrically, with proximal more than distal muscle involvement. Five cases were surgically treated with nerve transfers: spinal accessory to suprascapular nerve transfer (4 patients), branch of radial nerve to axillary nerve transfer (Somsak's procedure) (2 patients), and transfer of a fascicle of the ulnar nerve to the motor branch to the biceps (Oberlin's procedure) (1 patient). Motor improvement was seen in three cases. Widespread motor involvement was associated with poor outcome. This small series of cases reinforces that nerve transfers are a reliable option for treatment of selected children with AFM.