Acute flaccid myelitis: cause, diagnosis, and management.
Acute flaccid myelitis: cause, diagnosis, and management.
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DOI：
10.1016/s0140-6736(20)32723-9
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发表时间：
2021-01-23
期刊：
影响因子：
--
通讯作者：
AFM working group
中科院分区：
文献类型：
--
作者：
Murphy OC;Messacar K;Benson L;Bove R;Carpenter JL;Crawford T;Dean J;DeBiasi R;Desai J;Elrick MJ;Farias-Moeller R;Gombolay GY;Greenberg B;Harmelink M;Hong S;Hopkins SE;Oleszek J;Otten C;Sadowsky CL;Schreiner TL;Thakur KT;Van Haren K;Carballo CM;Chong PF;Fall A;Gowda VK;Helfferich J;Kira R;Lim M;Lopez EL;Wells EM;Yeh EA;Pardo CA;AFM working group
急性弛缓性肌麻痹（AFM）是一种致残性脊髓灰质炎样疾病，主要影响儿童。自2012年以来，AFM在全球多个地区爆发，该疾病似乎是由非脊髓灰质炎肠道病毒感染引起的，构成了重大的公共卫生挑战。临床表现为弛缓性和经常严重的肌无力（可能引起呼吸衰竭和其他严重并发症），可以模仿其他几种急性神经系统疾病。AFM没有单一的敏感性和特异性测试，诊断依赖于几个重要的临床，神经影像学和脑脊液特征的鉴定。在AFM急性期之后，患者通常具有实质性的残余残疾和独特的长期康复需求。在这篇综述中，我们描述了AFM的流行病学，临床特征，过程和结果，以帮助指导诊断，管理和康复。未来的研究方向包括评估宿主和病原体因素的进一步研究，包括调查受影响患者的遗传，病毒和免疫学特征，宿主-病毒相互作用，以及调查有针对性的治疗方法，以改善该人群的长期结局。
Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of AFM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for AFM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host–virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population.
影响因子：
1.7
作者：
Peediackal S;Jose J;Gafoor VA;Smitha B
通讯作者：
Smitha B