Acute flaccid myelitis (AFM) is a rare but serious neurological condition that impacts the spinal cord. The condition causes sudden weakness in the arms or legs, loss of reflexes, and loss of muscle tone.

The condition is similar to polio and mainly affects young children. It comes from a virus that is the common cold. Patients will begin with respiratory-like symptoms, like a cough and fever, then develop AFM.

Treating conditions like AFM requires a high level of pediatric neurology and rehabilitation expertise. Healthcare providers, especially nurse practitioners trained through online NP programs, play a crucial role in supporting these children.

In severe cases, the condition can lead to respiratory failure and even life-threatening body temperature changes. This is because AFM can also affect the breathing, neck, and belly muscles.

Statistics and treatment

Experts began first tracking acute flaccid myelitis following initial clusters in 2014, with the Center for Disease Control recognizing the condition in the same year. In the past decade, there have been 760 confirmed cases nationwide.

Currently, there is no specific treatment for AFM, and there is also no specific way to prevent the condition. Most health organizations recommend taking the same steps you would to avoid getting a viral infection, like washing hands and avoiding contact with sick people.

Researchers at Kennedy Krieger Institute’s International Center for Spinal Cord Injury (ICSCI) have published a new study however, titled ‘Transcutaneous Spinal Cord Stimulation Enables Recovery of Walking in Children with Acute Flaccid Myelitis’, outlining a potential new treatment for those living with AFM.

AFM study findings

The new study from researchers at the ICSCI was published in the journal Children, offering hope to children with acute flaccid myelitis through a new treatment. This study involved four children with AFM-related spinal cord injuries.

In the study, the children received a combination of Transcutaneous Spinal Cord Stimulation (TSS) and movement training. They received 22 therapy sessions consisting of the treatment, and the findings demonstrated it helped improve their ability to walk.

What is TSS?

Transcutaneous spinal cord stimulation is a non-invasive form of neuromodulation therapy. It involves electrodes (pads) being placed on the skin and used to stimulate the spinal circuitries via an electrical current.

Essentially, TSS amplifies the volume of signals traveling from the brain through the spinal cord. This process facilitates muscle activation and helps restore motor function in those with AFM.

The future of AFM treatment

Rebecca Martin, OTR/L, OTD, CPAM, and Manager of Clinical Education and Training at ICSCI and primary investigator of the study says the research shows that the combination of TSS and movement training is a safe, effective intervention that offers a new path for rehabilitation and improved quality of life.

“This treatment is giving families a long-awaited solution when they previously had no answers… Now our goal is to continue refining this approach and making it more widely available to these rare patients across the country,” said Martin.

Study results

The results of the study were promising. Three of the children showed improvements in walking distance, and out of those three—two had measurable gains in posture, speed, and overall walking function.

What causes acute flaccid myelitis?

Research has shown that acute flaccid myelitis might be caused by an infection with a type of virus known as enterovirus. Enterovirus itself is common in respiratory illnesses and fevers, especially in children.

Research has shown that an infection with a type of virus, known as enterovirus, can cause acute flaccid myelitis. While many respiratory illnesses and fevers from enterovirus are common in children and they recover—it can develop into AFM in extremely rare cases.

Researchers aren’t currently sure why some children recover from encountering enterovirus while others develop AFM. In the United States, it is most common for viruses, including enterovirus to circulate between August and November.

If you suspect that you or your child is showing signs of acute flaccid myelitis, it’s important to seek medical care as soon as possible. In severe cases, AFM can cause breathing difficulties and be life-threatening.

How is AFM diagnosed?

There is no simple way, like a blood test, for a physician to diagnose AFM. It can also be difficult for healthcare providers to diagnose because it shares similarities with many other neurological conditions, like polio and Guillain-Barré syndrome.

For a healthcare provider to diagnose a patient with AFM, it will be a multi-step process. It usually includes evaluating the patient’s symptoms and medical history, physical exams, neurological exams, and nerve response tests.

Outlook and recovery

Acute flaccid myelitis is still a relatively new condition, only being officially recognized by the CDC in 2014. So, researchers don’t know the long-term prognosis (outlook) for people with the condition.

Current data shows most people living with AFM tend to improve over time with physical therapy, but only less than 10% ever recover completely. Hopefully, the study and findings from the ICSCI can help improve this number, as the TSS treatment becomes accessible.