Acute flaccid myelitis (AFM) is a rare polio-like condition that may be the result of a viral infection. It affects the spinal cord, the part of the central nervous system that relays nerve signals between the brain and body. Specifically, it attacks an area of the spinal cord that contains motor nerve cells. Damage to motor nerve cells causes acute flaccid myelitis symptoms. Most often, AFM symptoms start with sudden muscle weakness and decreased muscle tone and reflexes. Other symptoms are possible, but sensory symptoms, such as numbness or tingling, are rare. Health experts are still learning about the cause of AFM. So far, most cases of AFM have affected young children. More than 90% of these children had symptoms consistent with a viral infection right before developing AFM. While adults can also get AFM, this is rare. There is no specific acute myelitis treatment. Doctors manage the disease with supportive measures. This may include physical therapy to improve weakness and other treatments as necessary. A pediatric neurologist can customize recommendations on a case-by-case basis. Experts do not yet fully understand the long-term prognosis for people with AFM. Seek medical care right away if you suspect a problem with your child’s muscle control. While AFM is rare, the symptoms are similar to other neurological diseases. Timely care is the best way to find a diagnosis and get appropriate care. The most common symptoms of AFM are muscle weakness, loss of muscle tone, and slow reflexes. These symptoms start suddenly and most often affect the arms and legs. Some people will also have the following symptoms: Difficulty moving their eyes Drooping eyelid or face Facial weakness Pain in the arms or legs (other sensory symptoms are rare) Slurred speech Trouble urinating Serious symptoms that might indicate a life-threatening condition AFM can be life threatening if it affects the muscles controlling breathing. This can lead to respiratory failure. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including: Anxiety or confusion Bluish skin, lips or nails Difficulty breathing, weak breathing, or shortness of breath Extreme sleepiness or loss of consciousness Feeling like you can’t get enough air or you are gasping for breath Wheezing The symptoms of AFM, including the respiratory symptoms, are similar to other conditions. Seeking care right away is vital, regardless of the cause. If it is AFM, your doctor may need to work with your local health department or CDC (Centers for Disease Control and Prevention). Collecting information about people who have AFM can help health experts better understand it. Health experts believe viruses play a role in AFM. More than 90% of people with AFM developed it after a mild respiratory infection or fever most likely due to a viral infection. However, scientists do not fully understand the connection between these viral infections and AFM. They are currently studying why and how AFM is triggered in people who develop it. Doctors ruled out poliovirus as a cause of AFM. The most likely place to find poliovirus when someone has it is in the stool. All stool samples from AFM patients tested negative for poliovirus. However, they have been able to isolate coxsackievirus in the spinal fluid of four people with AFM. This suggests it is a cause. Unfortunately, more than 500 people have developed AFM without any evidence of a virus in their spinal fluid. This could be because the body already cleared it or it is in an area where it is not detectable. It is also possible the virus itself isn’t the cause, but it triggers a reaction in the body, which then causes the symptoms of AFM. AFM is more common in young children about 4 years of age. Most of these children have developed AFM between the months of August and October. This is a common time of year for young children to become sick with enteroviruses, and coxsackievirus is a type of enterovirus. Doctors do not think acute flaccid myelitis is contagious. However, enteroviruses, including coxsackievirus, are contagious. AFM is possible, but rare in adults. Reducing your risk of AFM It is very difficult to prevent AFM without a full understanding of its cause. Because most children had some kind of mild viral infection before develop AFM, practicing good hygiene may help reduce the risk. This includes teaching your child to: Avoid close contact with people who may be sick Not touch their face, mouth, nose or eyes with unwashed hands Wash their hands often, especially before eating and after using the bathroom. Use soap and warm water and time the lather by singing the happy birthday song twice. You can help prevent the spread of viral infections by disinfecting surfaces that your child frequently touches. This includes toys, doorknobs, light switches, remotes, and other devices. Cover coughs and sneezes with a tissue or shirt sleeve, not your hand. And keep your child home when sick. There is no specific AFM treatment. Instead, doctors treat the symptoms with supportive therapies. Physical and occupational therapy can help children manage weakness in their arms and legs. Other treatments may be necessary depending on the individual case. Working with a pediatric neurologist can help ensure children get the most appropriate care based on their symptoms. AFM is not a new disease, but it is rare. The incidence of it has increased greatly in the last few years. As a result, health experts do not have a lot of information about the disease. Some people fully recover from AFM. However, most people still have muscle weakness a year after first developing AFM. Doctors do not know about the long-term outlook for people with AFM.