Acute Flaccid Myelitis: A Clinical Overview for 2019

Fatemi, Yasaman; Chakraborty, Rana

doi:10.1016/j.mayocp.2019.03.011

Cited by 23 publications

(33 citation statements)

References 17 publications

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“…Acute flaccid myelitis has been described prominently in enteroviral infections, and the role of immunomodulatory treatment is questionable. Although mainstay of management is supportive treatment, many patients have been treated with intravenous immunoglobulin (IVIG), high-dose corticosteroids, plasmapheresis, or a combination of these treatments because of the favorable risk-benefit ratio [3]. In view of normal MRI spine and presence of florid denervation in all tested muscles including bulbar muscles, most probable site of localization in our patient was anterior horn cell.…”

Section: Discussionmentioning

confidence: 90%

“…The predilection for anterior horn cell disease in viral infections though is not a novel proposition, as reduction in number of anterior horn cells has been described in in utero infections of mice models by Zika virus [2]. Although, in the pre-vaccination period, poliovirus was responsible for the most cases presenting with acute flaccid paralysis, wide spread vaccination has led to nonpolio enteroviruses being the number one cause of acute flaccid paralysis in today's era [3]. A case series on West Nile virus had reported the occurrence of possible anterior horn cell involvement in 5 of the reported 14 patients.…”

Section: Discussionmentioning

confidence: 99%

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Curious case of steroid responsive diffuse anterior horn cell disease associated with COVID-19 infection

et al. 2021

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Covid-19-associated neurological manifestations are being reported with increased frequency throughout the world. In a study from China, symptoms referable to peripheral nervous system (PNS) were described in approximately 9% of hospitalized Covid-19 patients. Common PNS symptoms reported in the study were loss of taste/smell and muscle pains. With this communication, we expand the spectrum of PNS manifestations of Covid-19 infection by reporting an association of steroid responsive diffuse anterior horn cell disease with Covid-19 infection from a tertiary care centre in India. Neurological manifestations of Covid-19 are diverse, and our case which to best of my knowledge is the first case in literature to report an occurrence of steroid responsive diffuse anterior horn cell disease associated with Covid-19 infection, adds to the ever-increasing spectrum of neurological manifestations associated with this pandemic causing virus. Good response to steroid in our case serves to provide an insight into the possible pathogenesis of this manifestation and also paves the way for future therapeutic decisions related to this association.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Curious case of steroid responsive diffuse anterior horn cell disease associated with COVID-19 infection

et al. 2021

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“…AFM has been shown to be temporally associated with enterovirus D68 and A71, although its causality has yet to be proven. [ 4 ] The typical clinical course of AFM involves unilateral paralysis of an extremity that may spread to other extremities. ATM, which our patient was diagnosed with, is less common, with an incidence of two out of 1,000,000 children affected each year.…”

Section: Discussionmentioning

confidence: 99%

Multiple extubation failures following a rhino-enteroviral infection

Annamalai

Bhalala

2021

Journal of Postgraduate Medicine

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This case report reviews the hospital course of a 15-month-old girl admitted to the PICU for acute respiratory failure due to enterovirus infection; who subsequently had multiple extubation failures secondary to acute transverse myelitis. This rare presentation highlights the importance of assessing the neurological status in a patient with rhino-enteroviral respiratory infection and of considering acute transverse myelitis as an etiology for difficulty with extubation.

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“…A subset of AFP called acute flaccid myelitis (AFM) represents a disease where paralysis and limb weakness typically occurs within a week of respiratory symptoms or fever caused by a nonpolio viral infection. In addition to the acute limb weakness, a lesion in the spinal cord gray matter that spans at least one vertebra and often elevated leukocyte counts within the CSF is a classic diagnostic feature (Dyda et al, 2018;Centers for Disease Control and Prevention,, 2019;Fatemi and Chakraborty, 2019). Symptoms result from inflammation followed by the loss of motor neurons within the brain stem and spinal cord without any signs of generalized encephalitis (Maloney et al, 2015;Hovden and Pfeiffer, 2015).…”

Section: Acute Flaccid Paralysis and Acute Flaccid Myelitismentioning

confidence: 99%

Molecular Pathogenicity of Enteroviruses Causing Neurological Disease

Majer¹,

McGreevy

Booth

2020

Front. Microbiol.

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Enteroviruses are single-stranded positive-sense RNA viruses that primarily cause self-limiting gastrointestinal or respiratory illness. In some cases, these viruses can invade the central nervous system, causing life-threatening neurological diseases including encephalitis, meningitis and acute flaccid paralysis (AFP). As we near the global eradication of poliovirus, formerly the major cause of AFP, the number of AFP cases have not diminished implying a non-poliovirus etiology. As the number of enteroviruses linked with neurological disease is expanding, of which many had previously little clinical significance, these viruses are becoming increasingly important to public health. Our current understanding of these non-polio enteroviruses is limited, especially with regards to their neurovirulence. Elucidating the molecular pathogenesis of these viruses is paramount for the development of effective therapeutic strategies. This review summarizes the clinical diseases associated with neurotropic enteroviruses and discusses recent advances in the understanding of viral invasion of the central nervous system, cell tropism and molecular pathogenesis as it correlates with host responses.

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Acute Flaccid Myelitis: A Clinical Overview for 2019

Cited by 23 publications

References 17 publications

Curious case of steroid responsive diffuse anterior horn cell disease associated with COVID-19 infection

Curious case of steroid responsive diffuse anterior horn cell disease associated with COVID-19 infection

Multiple extubation failures following a rhino-enteroviral infection

Molecular Pathogenicity of Enteroviruses Causing Neurological Disease

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