Fang Xiang, Huda Ruksana
Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA.
Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA.
J Clin Neurol. 2020 Jul;16(3):376-382. doi: 10.3988/jcn.2020.16.3.376.
Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. There is an increasing incidence of confirmed AFM cases in the USA and other countries in recent years, and in association with nonpolio enterovirus infection. This represents a significant challenge to clinicians and causes significant concern to the general public. Acute flaccid paralysis (AFP) is the long-known limb paralytic syndrome caused by a viral pathogen. AFM is a subset of AFP that is also characterized by a limb paralytic condition, but it has certain distinct features such as lesions in magnetic resonance imaging of the spinal cord gray matter. AFM leads to spinal cord, brainstem, or motor neuron dysfunction. The clinical phenotypes, pathology, and patient presentation of AFM closely mimic AFP. This article provides a concise overview of our current understanding of AFM and the clinical features that distinguish AFM from AFP and similar other neurological infectious and autoimmune diseases or disorders. We also discuss the diagnosis, clinical pathology, possible pathogenetic mechanisms, and currently available therapies.
急性弛缓性脊髓炎（AFM）是一种常见于幼儿的突发性、类似脊髓灰质炎的神经肌肉残疾。近年来，美国和其他国家确诊的AFM病例发病率不断上升，且与非脊髓灰质炎肠道病毒感染有关。这对临床医生构成了重大挑战，并引起了公众的极大关注。急性弛缓性麻痹（AFP）是一种由病毒病原体引起的广为人知的肢体麻痹综合征。AFM是AFP的一个子集，其特征也是肢体麻痹，但它有某些独特的特征，如脊髓灰质磁共振成像中的病变。AFM会导致脊髓、脑干或运动神经元功能障碍。AFM的临床表型、病理学和患者表现与AFP极为相似。本文简要概述了我们目前对AFM的认识，以及将AFM与AFP以及其他类似的神经感染性和自身免疫性疾病或病症区分开来的临床特征。我们还讨论了诊断、临床病理学、可能的发病机制以及目前可用的治疗方法。
