Akut Flask Miyelit
Özet
Akut flask miyelit, omurilik gri cevherinde lezyonlarla seyreden, asimetrik gevşek felçle karakterize poliomiyelit benzeri nöroinflamatuar bir hastalıktır. Genellikle enterovirüs D68 gibi virüslerle ilişkili olup, çoğunlukla 12 yaş altı çocukları etkileyen mevsimsel bir tablodur. Kesin bir tedavisi olmamakla birlikte, hastalığın yönetiminde erken dönem fizik tedavi ve destekleyici bakımlar ön plana çıkmaktadır.
Acute flaccid myelitis is a polio-like neuroinflammatory condition characterized by acute asymmetric flaccid paralysis and spinal gray matter lesions. It is often associated with non-polio enteroviruses, particularly EV-D68, and primarily affects children under 12 years of age with seasonal incidence. While no definitive cure exists, management relies heavily on early physical therapy and supportive care to address neurological sequelae.
Referanslar
Fatemi Y, Chakraborty R. Acute Flaccid Myelitis: A Clinical Overview for 2019. Mayo Clin Proc. 2019;94(5):875-81.
Helfferich J, Knoester M, Van Leer-Buter CC, Neuteboom RF, Meiners LC, Niesters HG, et al. Acute flaccid myelitis and enterovirus D68: lessons from the past and present. Eur J Pediatr. 2019;178(9):1305-15.
Van Haren K, Ayscue P, Waubant E, Clayton A, Sheriff H, Yagi S, et al. Acute Flaccid Myelitis of Unknown Etiology in California, 2012-2015. Jama. 2015;314(24):2663-71.
[Available from: https://www.cdc.gov/acute-flaccid-myelitis/index.html.
Kramer R, Lina B, Shetty J. Acute flaccid myelitis caused by enterovirus D68: Case definitions for use in clinical practice. Eur J Paediatr Neurol. 2019;23(2):235-9.
Knoester M, Helfferich J, Poelman R, Van Leer-Buter C, Brouwer OF, Niesters HGM. Twenty-nine Cases of Enterovirus-D68-associated Acute Flaccid Myelitis in Europe 2016: A Case Series and Epidemiologic Overview. Pediatr Infect Dis J. 2019;38(1):16-21.
Ruggieri V, Paz MI, Peretti MG, Rugilo C, Bologna R, Freire C, et al. Enterovirus D68 infection in a cluster of children with acute flaccid myelitis, Buenos Aires, Argentina, 2016. Eur J Paediatr Neurol. 2017;21(6):884-90.
Chong PF, Kira R, Mori H, Okumura A, Torisu H, Yasumoto S, et al. Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August-December 2015. Clin Infect Dis. 2018;66(5):653-64.
Andersen EW, Kornberg AJ, Freeman JL, Leventer RJ, Ryan MM. Acute flaccid myelitis in childhood: a retrospective cohort study. Eur J Neurol. 2017;24(8):1077-83.
Martin JA, Messacar K, Yang ML, Maloney JA, Lindwall J, Carry T, et al. Outcomes of Colorado children with acute flaccid myelitis at 1 year. Neurology. 2017;89(2):129-37.
Murphy OC, Pardo CA. Acute Flaccid Myelitis: A Clinical Review. Semin Neurol. 2020;40(2):211-8.
Messacar K, Schreiner TL, Van Haren K, Yang M, Glaser CA, Tyler KL, et al. Acute flaccid myelitis: A clinical review of US cases 2012-2015. Ann Neurol. 2016;80(3):326-38.
Kane MS, Sonne C, Zhu S, Malhotra A, Van Haren K, Messacar K, et al. Incidence, Risk Factors and Outcomes Among Children With Acute Flaccid Myelitis: A Population-based Cohort Study in a California Health Network Between 2011 and 2016. Pediatr Infect Dis J. 2019;38(7):667-72.
Ünver O, Türkdoğan D, Güler S, Kipoğlu O, Güngör M, Paketçi C, et al. Acute flaccid myelitis outbreak through 2016-2018: A multicenter experience from Turkey. Eur J Paediatr Neurol. 2021;30:113-20.
Pons-Salort M, Oberste MS, Pallansch MA, Abedi GR, Takahashi S, Grenfell BT, et al. The seasonality of nonpolio enteroviruses in the United States: Patterns and drivers. Proc Natl Acad Sci U S A. 2018;115(12):3078-83.
Sejvar JJ, Lopez AS, Cortese MM, Leshem E, Pastula DM, Miller L, et al. Acute Flaccid Myelitis in the United States, August-December 2014: Results of Nationwide Surveillance. Clin Infect Dis. 2016;63(6):737-45.
Hixon AM, Yu G, Leser JS, Yagi S, Clarke P, Chiu CY, et al. A mouse model of paralytic myelitis caused by enterovirus D68. PLoS Pathog. 2017;13(2):e1006199.
Van Dorn A. Acute flaccid myelitis in the USA. Lancet Child Adolesc Health. 2019;3(2):69.
Gordon-Lipkin E, Muñoz LS, Klein JL, Dean J, Izbudak I, Pardo CA. Comparative quantitative clinical, neuroimaging, and functional profiles in children with acute flaccid myelitis at acute and convalescent stages of disease. Dev Med Child Neurol. 2019;61(3):366-75.
Elrick MJ, Gordon-Lipkin E, Crawford TO, Van Haren K, Messacar K, Thornton N, et al. Clinical Subpopulations in a Sample of North American Children Diagnosed With Acute Flaccid Myelitis, 2012-2016. JAMA Pediatr. 2019;173(2):134-9.
Murphy OC, Messacar K, Benson L, Bove R, Carpenter JL, Crawford T, et al. Acute flaccid myelitis: cause, diagnosis, and management. Lancet. 2021;397(10271):334-46.
Okumura A, Mori H, Fee Chong P, Kira R, Torisu H, Yasumoto S, et al. Serial MRI findings of acute flaccid myelitis during an outbreak of enterovirus D68 infection in Japan. Brain Dev. 2019;41(5):443-51.
Hovden IA, Pfeiffer HC. Electrodiagnostic findings in acute flaccid myelitis related to enterovirus D68. Muscle Nerve. 2015;52(5):909-10.
Zhang Y, Moore DD, Nix WA, Oberste MS, Weldon WC. Neutralization of Enterovirus D68 isolated from the 2014 US outbreak by commercial intravenous immune globulin products. J Clin Virol. 2015;69:172-5.
Hurst BL, Evans WJ, Smee DF, Van Wettere AJ, Tarbet EB. Evaluation of antiviral therapies in respiratory and neurological disease models of Enterovirus D68 infection in mice. Virology. 2019;526:146-54.
Hixon AM, Clarke P, Tyler KL. Evaluating Treatment Efficacy in a Mouse Model of Enterovirus D68-Associated Paralytic Myelitis. J Infect Dis. 2017;216(10):1245-53.
Messacar K, Sillau S, Hopkins SE, Otten C, Wilson-Murphy M, Wong B, et al. Safety, tolerability, and efficacy of fluoxetine as an antiviral for acute flaccid myelitis. Neurology. 2019;92(18):e2118-e26.
Rhoden E, Zhang M, Nix WA, Oberste MS. In Vitro Efficacy of Antiviral Compounds against Enterovirus D68. Antimicrob Agents Chemother. 2015;59(12):7779-81.
Laffont I, Julia M, Tiffreau V, Yelnik A, Herisson C, Pelissier J. Aging and sequelae of poliomyelitis. Ann Phys Rehabil Med. 2010;53(1):24-33.
