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What is acute flaccid myelitis (AFM)?

Acute flaccid myelitis (AFM) is a neurologic disease. It is rare, but serious. It affects an area of the spinal cord called gray matter. This can cause the muscles and reflexes in the body to become weak. Because of these symptoms, some people call AFM a "polio-like" illness.

Researchers are trying to better understand AFM. They are working to learn more about what causes it and how to treat it.

What causes acute flaccid myelitis (AFM)?

There are a variety of possible causes of AFM, including viruses and environmental toxins (harmful substances in the environment).

In recent cases, most people had a mild respiratory illness or fever (like you would get from a viral infection) before they developed AFM.

Viruses that may cause AFM include

  • Enteroviruses such as poliovirus and enterovirus A71
  • West Nile virus (WNV)

In many cases, it is not possible to identify what caused AFM.

Who is at risk for acute flaccid myelitis (AFM)?

Anyone can get AFM, but most of the recent cases have been in children.

What are the symptoms of acute flaccid myelitis (AFM)?

Most people with AFM will suddenly have arm or leg weakness and a loss of muscle tone and reflexes. Some people also have other symptoms, including

  • Facial drooping/weakness
  • Trouble moving the eyes
  • Drooping eyelids
  • Trouble swallowing
  • Slurred speech

Sometimes AFM can weaken the muscles that you need for breathing. This can lead to respiratory failure, which is very serious. If you get respiratory failure, you may need to use a ventilator (breathing machine) to help you breathe.

If you or your child develops any of these symptoms, you should get medical care right away.

How is acute flaccid myelitis (AFM) diagnosed?

AFM causes many of the same symptoms as other neurologic diseases, such as transverse myelitis and Guillain-Barre syndrome. This can make it difficult to diagnose. To make a diagnosis, a doctor will

  • Do a neurologic exam, including looking at where there is weakness, poor muscle tone, and Decreased reflexes
  • Look at pictures of the spinal cord and brain. This may include images from an MRI.
  • Do lab tests on the cerebrospinal fluid (the fluid around the brain and spinal cord)
  • Check nerve speed (nerve conduction velocity) and the response of muscles to the messages from the nerves (electromyography)

It is important that the tests are done as soon as possible after the symptoms start.

What are the treatments for acute flaccid myelitis (AFM)?

There is no specific treatment for AFM. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) may recommend treatments for specific symptoms. For example, physical and/or occupational therapy may help with arm or leg weakness. Researchers do not know the long-term outcomes of people with AFM.

Can acute flaccid myelitis (AFM) be prevented?

You can take steps to help prevent infections of some of the viruses that may cause AFM:

  • Make sure that you and your children are up to date on polio vaccinations
  • Protect yourself and your children against bites from mosquitoes, which can carry West Nile virus
  • Protect yourself and your children from enteroviruses by
    • Washing your hands often with soap and water
    • Avoiding close contact with people who are sick
    • Cleaning and disinfecting surfaces that you frequently touch, including toys

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Rank Status Study
1 Unknown  Nurse Reduction of Pulled Elbow
Condition: Radial Head Subluxation
Intervention: Procedure: Reduction of Radial Head Subluxation
Outcome Measures: Proportion of patients with successful reduction of radial head subluxation by nurse, compared with physician controls;   Time to normal usage (minutes);   Time to discharge from ED (minutes);   Proportion of patients with presentation compatible with RHS, have reduction attempted, who are subsequently diagnosed with fracture.;   Proportion of patients with RHS not identified by nurse pathway.
2 Not yet recruiting Project 2: Strategies for Reducing Nicotine Content in Cigarettes
Conditions: Immediate Nicotine Reduction Group;   Gradual Nicotine Reduction Group;   Normal Nicotine Control Group
Intervention: Behavioral: Smoking Spectrum Brand Cigarettes for 20 weeks.
Outcome Measures: Toxicant exposure pattern;   Cigarettes per day;   Nicotine exposure;   Other toxicant exposure;   Effect biomarker;   Cessation rates;   Measure of acceptability;   Measure of acceptability: Non-compliance
3 Recruiting A Smoking Intervention Study Using Scheduled Gradual Reduction With Varenicline to Help With Cessation
Condition: Nicotine Addiction
Interventions: Other: Scheduled Gradual Reduction + Varenicline;   Other: Scheduled Gradual Reduction + Placebo Drug;   Other: Basic Advice + Varenicline;   Other: Basic Advice + Placebo Drug
Outcome Measures: Comparison of Prolonged Abstinence;   Comparison of Continuous Abstinence;   Comparison of Survival
4 Unknown  Behavioral Activation and HIV Risk Reduction for Men Who Have Sex With Men With Crystal Meth Abuse
Conditions: Crystal Methamphetamine Abuse;   Crystal Methamphetamine Dependence
Interventions: Behavioral: Behavioral Activation Therapy and Risk Reduction Counseling (BAT-RR);   Behavioral: Information, Motivation, Behavioral skills change approach to sexual risk reduction
Outcome Measures: Change in sexual risk;   Change in crystal methamphetamine use
5 Recruiting Volar Internal Plate Fixation vs. Plaster in Extra- Articular Distal Radial Fractures
Condition: Displaced Extra-articular Distal Radius Fractures
Interventions: Procedure: open reduction and internal fixation;   Other: Closed reduction and plaster
Outcome Measures: Wrist function/pain/disability at one year assessed with DASH score and PRWE score;   Quality of Life;   Pain;   Patient satisfaction;   Range of motion;   Grip strength;   Radiological parameters;   Complications
6 Recruiting Behavioral Drug and HIV Risk Reduction Counseling With MMT in China
Condition: Opiate Dependence
Interventions: Behavioral: Behavioral Drug and HIV Risk Reduction Counseling;   Behavioral: Educational Counseling;   Behavioral: Treatment as Usual
Outcome Measures: Reduction of drug- and sex-related HIV risk behaviors;   Reduction of frequency (days of illicit opiate use in each month) of heroin or other illicit opiate use;   Treatment retention;   Reductions in other illicit drug use;   Improvements of functional status (e.g., in vocational, family, and social functioning, and healthcare and other resource utilization)
7 Unknown  The Impact of Reducing Overtreatment on Quality of Life in Children With Refractory Epilepsy
Condition: Intractable Epilepsy
Interventions: Other: Reduction of anti-epileptic medications;   Procedure: No drug change
Outcome Measures: Effect of reduction in anti-epileptic medications on quality of life in young people with intractable epilepsy;   Identify other determinants of quality of life in this group of subjects
8 Recruiting BABY STEPS II: SMS Scheduled Gradual Reduction Text Messages to Help Pregnant Smokers Quit
Conditions: Smoking;   Pregnancy
Interventions: Behavioral: Scheduled Gradual Reduction Text Messages;   Behavioral: Support Text Messages
Outcome Measures: biochemically validated seven-day point prevalence smoking abstinence;   prolonged smoking abstinence;   biochemically validated smoking reduction;   biochemically validated postpartum smoking abstinence;   preterm birth
9 Recruiting Reduced Calorie Diet Intervention in Kidney Transplant Recipients
Condition: Chronic Kidney Disease
Intervention: Other: reduced calorie diet
Outcome Measures: a significant improvement in measures of body composition (including weight, BMI, and fat mass);   an improvement in insulin resistance;   a decrease in oxidative stress markers;   an improvement in kidney function
10 Recruiting Ablation and Left Atrium Reduction During Mitral Valve Surgery for Atrial Fibrillation
Condition: Atrial Fibrillation
Interventions: Procedure: maze procedure;   Procedure: mitral valve surgery;   Procedure: left atrial reduction
Outcome Measures: Freedom from atrial fibrillation;   Rate of significant adverse events
11 Not yet recruiting China Salt Substitute and Stroke Study
Condition: Stroke
Intervention: Behavioral: Dietary sodium reduction
Outcome Measures: Stroke;   Total major vascular events;   Total mortality
12 Recruiting Reduced Intensity Conditioning (RIC) Regimen for Patients With Non-malignant Disorders
Conditions: Non Malignant Diseases;   Immunodeficiencies;   Hemoglobinopathies
Intervention: Other: Hematopoetic Stem Cell Transplant using Reduced Intensity Conditioning Regimen
Outcome Measure: Engraftment and Survival
13 Unknown  Ultrasound Assisted Distal Radius Fracture Reduction
Conditions: Colles Fracture;   Point of Care Ultrasound;   Emergency Ultrasound
Intervention: Device: Point of care ultrasound
Outcome Measures: Efficacy of Point of care ultrasound in Identifying colles fracture reduction;   Number of reduction attempts affected by ultrasound;   Time to imaging
14 Recruiting Calcineurin-inhibitor Elimination/Reduction Randomized to Everolimus/Myfortic® vs Everolimus/Reduced Tacrolimus in Renal Transplant Recipients Following Campath® Induction
Condition: Renal Transplant
Interventions: Drug: Arm 1 Everolimus/myfortic®;   Drug: Arm 2 Everolimus/Reduced dose tacrolimus
Outcome Measures: Renal function;   Graft survival;   Biopsy proven acute rejection;   Patient survival;   Impaired glucose tolerance;   Proteinuria;   Lipid levels;   Mouth ulcers;   Gastrointestinal complaints;   Leukopenia;   Thrombocytopenia;   Neurotoxicity;   Pneumonitis;   Cytomegalovirus;   Infection requiring hospitalization;   BK infection;   BK nephropathy;   Malignancies;   Cardiovascular complications;   Development of donor specific antibody
15 Recruiting Peer Leaders as HIV Risk Reduction Change Agents Among Injection Drug Users (IDUs) in Ukraine
Conditions: HIV Infections;   Intervention
Interventions: Behavioral: Peer Education Model;   Behavioral: HIV Counseling and Education Model
Outcome Measures: HIV Knowledge;   Self-efficacy regarding HIV risk reduction;   Injection risk behavior reduction;   Sex-related risk behavior reduction;   Intervention diffusion to secondary network members
16 Recruiting Low Cost Biological Lung Volume Reduction Therapy for Advanced Emphysema
Condition: Advanced Pulmonary Emphysema
Intervention: Procedure: Bronchoscopic Lung volume reduction
Outcome Measures: Post-procedure lung volume reduction;   Post-procedure Improvement in dyspnea and exercise capacity
17 Not yet recruiting Reduced Nicotine Cigarettes in Smokers With Mood and Anxiety Disorders
Condition: Tobacco Dependence
Interventions: Drug: Reduced Nicotine Content Cigarettes;   Drug: Usual Nicotine Content Cigarettes
Outcome Measures: Plasma Cotinine Concentration;   Ratings of psychiatric and nicotine withdrawal symptoms
18 Recruiting Evaluation of the Efficacy of Platelets Treated With Pathogen Reduction Process
Condition: Aplasia With Expected Thrombocytopenia
Interventions: Biological: Autologous plasma;   Biological: Additive solution;   Biological: Pathogen reduction process
Outcome Measures: Incidence of grade 2 or higher (WHO) haemorrhagic episodes;   Frequency incidence of haemorrhagic episodes (grade 1 and higher);   Number of serious grade 3-4 haemorrhagic episodes;   Number of minor grade 1 haemorrhagic episodes;   Transfusion outcome in platelets (CCI) at 24 hours;   Number of transfusions of platelet concentrates and red blood cells;   Transfusion intervals;   Safety (transfusion side effects) grade 2 or higher;   Occurrence of anti-platelet antibodies (Anti-HLA, anti-HPA);   Occurrence of platelet transfusions refractiveness;   Validation of a new haemorrhagic evaluation: EFS scale;   Variation in hematocrit and hemoglobin levels
19 Unknown  Effectiveness Study of the UltraShape® Contour I-Y for Non-Invasive Reduction in Abdominal Circumference
Condition: Reduction in Abdominal Circumference
Intervention: Device: Treatment with Contour I-Y system
Outcome Measures: The primary objective of this study is to evaluate the efficacy of the Contour I - Y System on abdominal circumference reduction relative to baseline pretreatment values using different treatment methods.;   The secondary objective of this study subject satisfaction measured with a self-assessment questionnaire;   Rate of device and procedure related adverse event adverse
20 Recruiting Enhancing Panic and Smoking Reduction Treatment With D-Cycloserine
Conditions: Nicotine Addiction;   Panic Attack
Interventions: Drug: d-cycloserine;   Drug: Pill Placebo;   Drug: Nicotine replacement therapy;   Behavioral: Panic and Smoking Reduction Treatment
Outcome Measure: Smoking Status