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Acute Flaccid Myelitis — RACP Paediatrics MCQ

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HardNeurology & DevelopmentAcute Flaccid MyelitisRACP Paediatrics

A 3-year-old child presents with acute flaccid paralysis affecting one leg following a febrile illness. Reflexes are absent in the affected limb. MRI shows enhancement of the anterior horn cells in the lumbar spinal cord. What is the most likely diagnosis?

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Correct answer: B — Acute flaccid myelitis

Acute flaccid myelitis (AFM) is an enterovirus (particularly EV-D68)-associated condition presenting with acute onset limb weakness, absent reflexes, and anterior horn cell involvement on MRI (similar to poliomyelitis). It differs from GBS (peripheral nerve involvement) and TM (complete cord involvement). Treatment is supportive; prognosis for motor recovery is variable.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Acute Flaccid Myelitis