Pin Fee Chong, Ryutaro Kira, Hiroyuki Torisu, Sawa Yasumoto, Akihisa Okumura, Harushi Mori, Keiko Tanaka-Taya, for the AFM Study Group. Three-year longitudinal motor function and disability level of acute flaccid myelitis. Pediatric Neurology. Published:December 03, 2020 DOI:https://doi.org/10.1016/j.pediatrneurol.2020.11.019
Abstract
Background
We summarize the long-term motor outcome and disability
level in a cluster of pediatric patients with acute flaccid myelitis (AFM)
associated with the enterovirus D68 (EV-D68) outbreak in 2015.
Methods
This is a nationwide follow-up questionnaire analysis study.
Clinical data including the motor function (manual muscle strength test) and
other neurological symptoms were collected at the acute (nadir), recovery (6
months) and chronic (3 years) stages. We use the Barthel index which measures
ten variables describing activity of daily living and mobility to assess the
disability level.
Results
Clinical data of 33 patients with AFM (13 females, 20 males;
median age=4.1 years) were available. Among patients with tetraplegia or
triplegia, paraplegia, and monoplegia at the acute stage, 2/7, 4/13, and 2/13
exhibited complete recovery without paralysis, out of those 5/7, 8/13, and 2/13
who showed improvement with lesser limb involvement at the chronic stage,
respectively. Nine patients (27%) demonstrated improvement at the
recovery-to-chronic period. All six patients with positive isolation of EV-D68
from biological samples at the acute stage showed persistent motor deficits.
Other neurological findings had better prognosis than motor weakness. Better
Barthel index score at the chronic stage was observed [ p<0.001; median
difference (95% confidence interval), 53 (40–63)], implying an improved
disability level even in patients with persistent motor deficits.
Conclusions
AFM has a high rate of persistent motor deficits showing 1–2
limb paralysis. Disability level of patients with AFM, however, generally
improved at the 3-year time point.
Courtesy of: https://www.mdlinx.com/journal-summary/three-year-longitudinal-motor-function-and-disability-level-of-acute-flaccid-myelitis/2M0PoTohJOzciFC1NCdbN7
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