Pediatric Electromyography by Hugh J. McMillan & Peter B. Kang

Author:Hugh J. McMillan & Peter B. Kang
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Infectious Etiologies

Occasionally, infectious diseases cause predominantly motor neuron degeneration with weakness. The sensory system is clinically spared. The term “acute flaccid myelitis” (AFM) is often used to refer to cases of acute flaccid weakness with spinal cord gray matter lesions on imaging or evidence of spinal cord motor neuron injury on electrodiagnostic testing (Table 16.3). AFM develops abruptly and progresses rapidly, usually after a prodromal febrile illness, with uniformly flaccid weakness involving one or more limbs and areflexia or hyporeflexia. Loss of bladder and bowel function may develop [101]. Poliomyelitis is the prototypical AFM; other subtypes include those associated with Hopkins syndrome, West Nile Virus, enteroviruses, and Japanese encephalitis.

In AFM, sensory responses are usually spared. CMAP amplitudes are consistently low after the first 3 weeks. After the first week, reduced recruitment and fibrillation potentials are seen, and this pattern persists for months [101].

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