1. Outcomes of Colorado children with acute flaccid myelitis at 1 year.
- Author
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Martin JA, Messacar K, Yang ML, Maloney JA, Lindwall J, Carry T, Kenyon P, Sillau SH, Oleszek J, Tyler KL, Dominguez SR, and Schreiner TL
- Subjects
- Adolescent, Atrophy pathology, Child, Child, Preschool, Colorado, Cranial Nerve Diseases diagnostic imaging, Cranial Nerve Diseases etiology, Cranial Nerve Diseases physiopathology, Electromyography, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Movement Disorders diagnostic imaging, Movement Disorders etiology, Movement Disorders physiopathology, Muscular Diseases diagnostic imaging, Muscular Diseases etiology, Muscular Diseases physiopathology, Myelitis complications, Myelitis diagnostic imaging, Myelitis physiopathology, Neural Conduction physiology, Patient Reported Outcome Measures, Cranial Nerve Diseases diagnosis, Movement Disorders diagnosis, Muscle, Skeletal physiopathology, Muscular Diseases diagnosis, Myelitis diagnosis, Outcome Assessment, Health Care methods
- Abstract
Objective: We describe long-term functional, neurodiagnostic, and psychosocial outcomes of a cohort of 12 children from Colorado diagnosed with acute flaccid myelitis (AFM) in 2014., Methods: Children were assessed every 3 months for 1 year or until clinical resolution. Assessments included neurologic examination, MRI, EMG/nerve conduction studies (NCS), functional measures (Assisting Hand Assessment, Hammersmith Functional Motor Scale), and Patient-Reported Outcomes Measurement Information System questionnaires., Results: Eight of 12 children completed the study. Six of 8 had persistent motor deficits at 1 year; 2 demonstrated full recovery. Four were not enrolled, 2 of whom reported full recovery. The 6 affected were weakest in proximal muscles, showing minimal to no improvement and significant atrophy at 1 year. All patients improved in distal muscle groups. Cranial nerve dysfunction resolved in 2 of 5 and improved in all. Four of 5 showed progressive functional improvement at 6 and 12 months. Two of 8 reported pain at 1 year. Three of 8 reported depressive symptoms. Repeat MRI was performed in 7 of 8 children a median of 7 months after onset and showed significant improvement or normalization in all but one child. Repeat EMG/NCS was performed on 4 children a median of 8 months after onset and showed ongoing denervation and chronic reinnervation in 3 children with persistent deficits., Conclusions: At 1 year, children with AFM demonstrated functional gains but weakness persisted. EMG changes correlated with persistent deficits better than imaging. Despite improvements, AFM had substantial long-term functional effects on affected children., (© 2017 American Academy of Neurology.)
- Published
- 2017
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