Pediatric Spinal Cord Injury Due to Acute Flaccid Myelitis: Epidemiology, Clinical Management, and Implications for Rehabilitation

Abstract

Acute flaccid myelitis (AFM) is a recently described rare syndrome causing spinal cord injury in children. The purpose of this review is to describe the epidemiology of AFM, clinical presentation, and management. We further describe outcomes, rehabilitation strategies, and future directions for this group of children. Outbreaks of Enterovirus D-68 (EV D-68) starting in 2014 coincided with increase in acute flaccid paralysis cases in children which were tracked by the Centers for Disease Control and Prevention (CDC). CDC provided guidelines for identification and management of cases of AFM. Long-term follow-up has not been sufficient but children with AFM have a wide range of presentation and residual disability following the illness. Further studies are needed to assess long-term outcomes and to help prevent AFM. The epidemiology and acute management of AFM is well described in the literature but long-term follow-up and outcomes remain needed, especially regarding long-term disability from spinal cord injury. Additional studies are needed to provide further evidence of best practice and possible prevention.