急性弛缓性脊髓炎
定义
急性弛缓性脊髓炎 is a rare condition that affects the nervous system. Inflammation of the gray matter in the spinal cord leads to muscle weakness 和 paralysis.
急性弛缓性脊髓炎 (AFM) is usually caused by infection with a virus. While AFM is rare, there has been a slight increase in cases of AFM since 2014. Most new cases have occurred in children or young adults.
选择的名字
急性弛缓性脊髓炎; AFM; Polio-like syndrome; Acute flaccid paralysis; Acute flaccid paralysis with anterior myelitis; Anterior myelitis; Enterovirus D68; Enterovirus A71
原因
AFM usually occurs after a cold, fever, or gastrointestinal illness.
Different kinds of viruses may be the cause of AFM. 这些包括:
- Enteroviruses (poliovirus 和 non-poliovirus)
- West Nile virus 和 similar viruses such as Japanese encephalitis virus 和 Saint Louis encephalitis virus
- 腺病毒
It is unclear why certain viruses trigger AFM, or why some people develop the condition 和 others don't.
Environmental toxins also can cause AFM. In many cases, a cause is never found.
症状
A fever or a respiratory illness is often present before weakness 和 other symptoms begin.
AFM symptoms often start with sudden muscle weakness 和 loss of reflexes in an arm or leg. 症状 may progress rapidly over a few hours to days. 其他症状可能包括:
- 面部下垂或虚弱
- 下垂的眼睑
- 眼睛移动困难
- Slurred speech or difficulty swallowing
有些人可能有:
- 颈部僵硬
- 手臂或腿部疼痛
- 不能排尿
严重症状包括:
- Respiratory failure, when muscles involved in breathing become weak
- Serious nervous system problems, which may lead to death
考试和测试
Your health care provider will take your medical history 和 vaccination history to know if you are up-to-date with your 脊髓灰质炎疫苗s. Unvaccinated individuals who are exposed to poliovirus are at higher risk for acute flaccid myelitis. Your provider also may want to know if within the last 4 weeks you have:
- 旅行
- Had a cold or the flu or a stomach bug
- Had a fever 100°F (38°C) or higher
Your provider will do a physical exam. 可以进行的测试包括:
脊柱MRI 和脑部核磁共振 to view lesions in the gray matter神经传导速度测验 肌电图(EMG) Cerebrospinal fluid (CSF) analysis to check if white blood cells are elevated
Your provider also may take stool, blood, 和 saliva samples to test.
治疗
There is no specific treatment for AFM. You may be referred to a doctor specializing in disorders of the nerves 和 nervous system (neurologist). The doctor will likely treat your symptoms.
A number of medicines 和 treatments that work on the immune system have been tried but have not been found to help.
You may need physical therapy to help restore muscle function.
前景(预测)
The long-term outlook of AFM is not known.
可能出现的并发症
AFM的并发症包括:
- 肌肉无力和麻痹
- 肢体功能丧失
When to Contact a Medical Professional
Contact your provider right away if you or your child have:
- Sudden weakness in the arms or legs or difficulty moving the head or face
- AFM的其他症状
预防
There is no known way to prevent AFM. 有一个
Take these steps to help avoid viral infections:
- Wash h和s frequently with soap 和 water, especially before eating.
- Avoid close contact with people who have a viral infection.
- Use mosquito repellants when going outdoors to prevent mosquito bites.
To learn more 和 get recent updates, go to the CDC webpage about acute flaccid myelitis at
参考文献
Centers for Disease Control 和 预防 website. 急性弛缓性脊髓炎.
Kapadia RK, Pastula DM, Glaser CA. Parainfectious 和 postinfectious neurologic syndromes. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles 和 Practice of Pediatric Infectious Diseases. 6日艾德. Philadelphia, PA: Elsevier; 2023:chap 45.
梅萨卡·K,艾布扎格·MJ. 肠病毒和喉病毒. In: Long SS, Prober CG, Fischer M, Kimberlin DW, eds. Principles 和 Practice of Pediatric Infectious Diseases. 6日艾德. Philadelphia, PA: Elsevier; 2023:chap 236.
审核日期: 11/02/2022
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