- Symptoms of acute flaccid myelitis
- How to confirm the diagnosis
- What causes acute flaccid myelitis
- How the treatment is done
Acute flaccid myelitis is an inflammation, sometimes confused with polio, Guillian-Barré syndrome or traumatic neuritis, because it generates symptoms such as back pain, muscle weakness, with decreased sensitivity and paralysis of the legs and / or arms.
Its main characteristic is the inflammation of the spine that leaves the muscles very weak and soft, causing paralysis. This inflammation is usually caused by an infection, but it can also happen due to an autoimmune disease, which ends up attacking the cells of the spinal cord.
Although it is not always possible to completely cure acute flaccid myelitis, it is possible to do treatment with drugs and physical therapy to control symptoms and restore quality of life.
Symptoms of acute flaccid myelitis
The first symptoms of acute flaccid myelitis are similar to the flu, with sneezing, coughing, malaise for 3-7 days, then appear:
- Spinal pain, especially in the lower back; Tingling or burning sensation in the chest, abdomen, legs or arms; Weakness in the arms or legs, with difficulty holding objects or walking; Tilting the head forward, and difficulty swallowing; Difficulty holding urine or feces.
Since myelitis can affect the myelin sheath of nerve cells, the transmission of nerve stimuli is more impaired over time and, therefore, it is common for symptoms to get worse every day, becoming more intense, there may even be paralysis, which prevents the person from walking.
When the portion of the spine affected is lower, the child may not walk for life, and when the affected area is close to the neck, the affected person may lose shoulder and arm movements. In the most severe cases, it may be difficult to breathe and swallow, requiring hospitalization.
Thus, whenever symptoms appear that may indicate a problem with the spine, it is very important to consult a general practitioner, for example, to identify the cause and start treatment, before lesions that are difficult to resolve arise. In this situation, after diagnosis it is normal for the person to be referred to a neurologist.
How to confirm the diagnosis
To make the diagnosis of acute flaccid myelitis, a general practitioner or neurologist should be consulted, when there is a lot of suspicion of a problem in the spine. The doctor, in addition to assessing symptoms and a history of illness, usually also orders some diagnostic tests, such as MRI, lumbar puncture and various blood tests, which help to screen for other diseases.
What causes acute flaccid myelitis
It is not yet known what the exact cause of acute flaccid myelitis is, however, there are some conditions that seem to increase the risk of developing this problem, such as:
- Viral infections, especially in the lung ( Mycoplasma pneumoniae ) or in the digestive system; Enteroviruses, such as EV-A71 and EV-D68; Rhinovirus; Parasitic infections, such as toxoplasmosis or cystecircosis; Multiple sclerosis; Neuromyelitis optica; Autoimmune diseases, such as lupus or syndrome of Sjogren.
Although it is very rare, there are also reports of cases of acute flaccid myelitis that arose after taking a vaccine against hepatitis B or against measles, mumps and chickenpox.
How the treatment is done
The treatment of myelitis varies greatly according to each case, but it is usually started with the use of medicines to treat possible infections, reduce the inflammation of the spinal cord and relieve the symptoms, improving the quality of life. Some of the most commonly used medications include:
- Injectable corticosteroids, such as Methylprednisolone or Dexamethasone: quickly reduce inflammation of the spinal cord and decrease the response of the immune system, relieving symptoms; Plasma exchange therapy: it is used in people who have not improved with the injection of corticosteroids and works by removing excess antibodies that may be causing the inflammation of the spinal cord; Antiviral remedies: to treat any possible viral infection that is active and harming the spinal cord; Analgesics, such as acetaminophen or naproxen: to relieve muscle pain and any other type of pain that may arise.
After this initial therapy, and when the symptoms are more controlled, the doctor can advise physiotherapy sessions to help strengthen the muscles and train coordination, which may be affected by the disease. Although physical therapy cannot cure the disease, it can greatly improve muscle strength, coordination of movements, facilitating hygiene and other day-to-day tasks.
In some cases, occupational therapy sessions may still be necessary, so that the person learns to do daily activities with the new limitations that may arise with the disease. But in many cases there is a full recovery in a few weeks or months.
