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Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host-virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.

AbstractPurposeof review: Neurological complications are increasingly recognized in the Coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This coronavirus is related to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and other human coronavirus-related illnesses that are associated with neurological symptoms. These symptoms raise the question of a neuroinvasive potential of SARS-CoV-2.Recent findings:Potential neurological symptoms and syndromes of SARS-CoV-2 include headache, fatigue, dizziness, anosmia, ageusia, anorexia, myalgias, meningoencephalitis, hemorrhage, altered consciousness, Guillain-Barré Syndrome, syncope, seizure, and stroke. Additionally, we discuss neurological effects of other coronaviruses, special considerations for management of neurological patients, and possible long-term neurological and public health sequelae.Summary:As SARS-CoV-2 is projected to infect a large part of the world’s population, understanding the potential neurological implications of COVID-19 will help neurologists and others recognize and intervene in neurological morbidity during and after the pandemic of 2020.