Acute myelastic myelitis (AFM) is a disease that has been known in medicine for a long time. However, due to the fact that since 2014 more and more cases of it have started to be recorded, recently it has started to be mentioned more and more often. The problems with AFM are both that the causes of this entity are unknown and that currently medicine does not have any treatments available for this condition. What is the characteristic of acute muscle relaxant myelitis and why recently have there been many charges against the American CDC in connection with AFM?
Acute flaccid myelitis(AFM) is a disease that can occur at any age, but the vast majority of cases are reported in children . It is not a disease that would only recently begin to appear in the human population.
AFM has been known to medics for a long time, but in the last few years it has been mentioned more because more and more cases of this unit have started to appear.
We are talking primarily about the United States and the cases of AFM that took place in that country. It all started in 2014, with 120 cases of acute myel relaxant in the United States.
In 2015, there were 22 cases, in 2016 - 149, and in 2022, 33 US citizens fell ill with AFM.
In 2022 - until the beginning of November - acute relaxant myelitis was diagnosed in 80 people in the United States.
Considering the above numbers, it is not hardly surprising that AFM began to attract the attention of medics - they began to search for the causes of this disease, as well as methods of its treatment.
Acute Relaxing Myelitis (AFM): Causes
The doctors managed to obtain some information about acute muscle relaxant myelitis - it is already known that this entity is found primarily in children and adolescents.
It has also been noticed that the most cases of the disease occur in the fall and winter season. However, there are still many ambiguities - it is still unknown what they arecauses of acute muscle relaxant myelitis.
AFM can certainly be considered a rather controversial entity today - various charges have been (and still are) directed at the U.S. Centers for Disease Control and Prevention (CDC).
Medical specialists accuse the organization of, for example, slowness in searching for the factors responsible for the occurrence of this unit, and the CDC is also criticized for the fact that specialists have still not managed to find effective methods of treatment and prevention of this disease.
The allegations are hardly surprising, but on the other hand, it should be emphasized that - despite many efforts and research - AFM is still one of the most enigmatic diseases.
Various factors are recognized as potential causes of acute muscle relaxant myelitis. Currently, the dominant view is that genetic and environmental factors as well as various types of viruses are involved in the pathogenesis of an individual.
Many pathogens have already been associated with AFM, a correlation was searched for, e.g. between this disease and infections with polio viruses or enteroviruses.
Currently, however, the enterovirus D68 attracts the most attention. The association of this pathogen with acute muscle relaxant myelitis comes from the observation that a large number of AFM cases in 2014 coincided with the American epidemic of respiratory infections caused by this enterovirus.
It must be stated unequivocally that it is this microorganism that causes the disease, but definitely not - just as some people with AFM actually had this virus, so it was not detected in others.
Little is known about acute sclerosing myelitis - it is unclear, for example, why in even years (2014, 2016 or 2022) there are definitely more cases than in odd years.
Scientists still have a lot to do - luckily, the symptoms of this disease have been discovered much more than the causes of AFM.
Acute Relaxing Myelitis (AFM): Symptoms
The most distinctive feature of the disease is that the symptoms of acute muscle relaxant myelitis develop suddenly.
Patients develop nervous system abnormalities, usually in the form of muscle weakness and loss of muscle tone in the arms or legs.
Besides them, symptoms of AFM canalso include:
- facial muscle weakness
- eye movement impairment
- ptosis
- swallowing difficulties
- speech disorders (usually in the form of difficulty articulating words)
Less frequent symptoms in patients with acute myelastic myelitis are:
- urinary incontinence
- pain in weakened limbs
- weakening of the respiratory muscles leading to respiratory disorders
In some patients with AFM, neurological symptoms are preceded by completely different ailments. It happens that, before muscle weakness, the patient develops symptoms suggesting a respiratory system infection, such as a sudden deterioration in well-being, increased body temperature or coughing.
Acute Relaxing Myelitis (AFM): Diagnosis
Due to the fact that doctors still do not know everything about AFM, diagnostic algorithms for this unit have not yet been developed.
When a disease is suspected, a neurological examination is first carried out - during it, it is possible to detect the abovementioned deviations.
Imaging tests are also important - in the case of acute muscle relaxant myelitis, during magnetic resonance imaging of the spinal cord, it is possible to visualize the altered tissues of the spine (it is even mentioned that demonstrating these changes - along with the occurrence of symptoms typical of AFM - it is required to be able to recognize this disease).
Lumbar puncture can also be performed on patients - in the resulting cerebrospinal fluid, pleocytosis, i.e. an increased number of cells, is possible in the case of acute myelitis.
The above-mentioned tests are important not only for the possible diagnosis of AFM - they are also performed to exclude other potential causes of the patient's symptoms.
Acute spinal myelitis requires differentiation with many diseases, incl. with Guillain-Barré syndrome and with transverse myelitis.
Acute Relaxant Myelitis (AFM): Treatment
Currently, medicine does not have any methods of treating acute muscle relaxant myelitis - in principle, only symptomatic treatment is offered to patients.
The use is in this case primarily for physiotherapy, thanks to which it is possible to obtain improvement in terms ofthe activities of the patient's weakened muscles.
However, there are reports of more and more methods, the use of which could restore the fitness of patients with AFM. For example, there is mention of a surgical treatment, during which the damaged nerve fibers of patients would be replaced with properly functioning nerves obtained from some other parts of the body.
This type of therapy was conducted by Mitchel Seruya from Children's Hospital in Los Angeles, and so far it has produced quite promising results - the physician has managed to improve the condition of 14 out of 15 children undergoing surgery.
Acute myelastic myelitis (AFM): prognosis
At this point, it is difficult to talk about the prognosis of patients with acute myelaginitis.
In some patients - especially those with a small degree of neurological deficits - it even spontaneously improves after some time, while in others the loss of muscle strength remains for a long time and can only help in their recovery. rehabilitation.
It is still unknown, however, whether the completion of AFM results in the occurrence of any other difficulties in the future.
Acute Relaxing Myelitis (AFM): Prevention
Until the factor responsible for the occurrence of acute spinal cord relaxation is known, it is really hard to find ways to prevent it.
Theoretically, it would be possible to develop a vaccine against this disease - but it cannot be created yet, because we do not know against which pathogen this vaccination would protect.
Currently, the only thing that can be done to reduce the risk of contracting the disease is to follow the general principles of reducing the risk of infection. We are talking here about frequent hand washing or avoiding staying in crowded places when in the autumn and winter season the highest number of respiratory infections occurs.