Physical Medicine and Rehabilitation Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Pediatric Health Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Pediatr Rehabil Med. 2022;15(2):369-376. doi: 10.3233/PRM-200798.
Acute flaccid myelitis (AFM) is an acute condition occurring mostly in children. Although affected patients can show a broad spectrum of symptoms, it is mainly characterized by the progressive onset of focal limb weakness, presenting over a period of hours to a week, with or without pain, and spinal cord gray matter involvement on magnetic resonance imaging (MRI). There is compelling evidence to support the role of viruses, in particular enteroviruses. Studies describing electrodiagnostic (EDX) abnormalities and long-term outcomes in AFM are limited. In this report, the clinical presentation, EDX and MRI findings, and long-term outcomes in three children with AFM who presented with progressive and asymmetric weakness of the limbs are described. MRI showed a long segment cervicothoracic lesion with vertical expansion in all three cases. Patients do recover in time, but many continue to have permanent muscle weakness in the worst affected part(s), and complete recovery is rare. Follow-up of these three cases at 18 months demonstrated a partial recovery in the motor system.
急性弛缓性脊髓炎（AFM）是一种主要发生在儿童中的急性疾病。尽管受影响的患者可能表现出广泛的症状，但主要表现为局灶性肢体无力进行性发作，在数小时至一周内出现，可伴有或不伴有疼痛，磁共振成像（MRI）显示脊髓灰质受累。有强有力的证据支持病毒，特别是肠道病毒的作用。描述 AFM 中电诊断（EDX）异常和长期结局的研究有限。在本报告中，描述了 3 例以四肢进行性和不对称性无力为表现的 AFM 患儿的临床表现、EDX 和 MRI 结果以及长期结局。MRI 显示所有 3 例均存在长节段颈胸段病变，垂直扩展。患者确实会及时恢复，但许多患者在受影响最严重的部位仍持续存在永久性肌肉无力，完全恢复很少见。对这 3 例患者进行 18 个月的随访显示运动系统有部分恢复。
