Pediatric Rehabilitation Lecture Series: Transverse Myelitis and Acute Flaccid Myelitis-Pediatric Rehabilitation Lecture Series: Transverse Myelitis and Acute Flaccid Myelitis

Pediatric Rehabilitation Lecture Series: Transverse Myelitis and Acute Flaccid Myelitis

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Video Summary

Dr. Brea, a pediatric rehabilitation fellow at Gillette Children's Hospital, presented a lecture on acute flaccid myelitis (AFM) and transverse myelitis (TM) in pediatric rehabilitation. AFM is characterized by flaccid paralysis due to inflammation of the spinal cord gray matter, while TM involves acute immune-mediated inflammation of gray and white matter in the spinal cord. AFM is most commonly seen in young children and is often preceded by a viral prodrome. The strongest association is with enteroviruses. TM can occur at any spinal level and is often preceded by pain. Sensory deficits and autonomic dysfunction are more common in TM. Diagnosis is made through a combination of clinical presentation, MRI, and CSF analysis. Treatment for both conditions is mainly supportive, with high-dose steroids being the first line of therapy for TM. The prognosis for AFM is generally worse, with less than 10% of patients recovering completely. Sensory disturbances and bladder dysfunction are common sequelae in TM. Rehabilitation and therapy should be started early and focus on maximizing outcomes and reaching developmentally appropriate milestones. A recent study compared the diagnostic criteria for AFM and TM and found that certain criteria can effectively differentiate between the two conditions. Overall, accurate diagnosis and appropriate management are essential for improving outcomes in patients with AFM and TM.

Keywords

acute flaccid myelitis

transverse myelitis

pediatric rehabilitation

spinal cord inflammation

enteroviruses

diagnosis

treatment

prognosis