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Acute flaccid myelitis outbreak through 2016–2018: A multicenter experience from Turkey
- Source :
- European Journal of Paediatric Neurology. 30:113-120
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Aim We aim to describe the demographic characteristics, etiology, neurophysiology, imaging findings, treatment, prognosis, and prognostic factors of acute flaccid myelitis. Methods The clinical data, laboratory test and, magnetic resonance imaging (MRI) results of pediatric patients diagnosed with acute flaccid myelitis according to the Centers for Disease Control criteria between August 1, 2016, and December 31, 2018, from 13 centers in Turkey were reviewed. Results Of the 34 cases identified, 31 were confirmed (91.2%). Eighteen patients (55.9%) were boys. The median patient age was 4 years (interquartile range 2.5–6.9 years). Most of the patients were admitted in 2018 (n = 27). A preceding history of a febrile illness was reported in all patients, with a median of 4 days (interquartile range 3–7 days) before symptom onset. Thirty-one patients had T2 hyperintensity on spinal MRI, and 18 patients had cerebrospinal fluid pleocytosis. The most common infectious agents were entero/rhinoviruses (n = 5) in respiratory specimens. All patients except one received immunotherapy either alone or in combination. Among 27 patients with follow-up data 24 had persistent weakness. Involvement of four limbs together with an abnormal brain MRI at onset were associated with a poor prognosis. Conclusion The number of patients with acute flaccid myelitis increased since 2012, spiking with every 2-year interval, largely in the pediatric population. The median age decreases with every outbreak. Clinicians should be aware of the clinical picture for early collection of specimens and early start of rehabilitation programs. Further studies are needed to better characterize the etiology, pathogenesis, risk factors, and treatment of this rare condition.
- Subjects :
- Male
Enterovirus D-68
Pediatrics
medicine.medical_specialty
Weakness
Adolescent
Turkey
medicine.disease_cause
Disease Outbreaks
03 medical and health sciences
0302 clinical medicine
Interquartile range
030225 pediatrics
medicine
Polio-Like Disease
Humans
Child
Enterovirus
Retrospective Studies
Acute Flaccid Paralysis
medicine.diagnostic_test
business.industry
Infant
Outbreak
Magnetic resonance imaging
Neuromuscular Diseases
General Medicine
Myelitis
Prognosis
Acute flaccid myelitis
Hyperintensity
Child, Preschool
Pediatrics, Perinatology and Child Health
Central Nervous System Viral Diseases
Etiology
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 10903798
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- European Journal of Paediatric Neurology
- Accession number :
- edsair.doi.dedup.....de9976c62c7248003110fb3d24d73423