{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T04:02:40Z","timestamp":1772510560341,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T00:00:00Z","timestamp":1498089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1031893"],"award-info":[{"award-number":["1031893"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Clusters of acute limb weakness in paediatric patients have been linked to outbreaks of non\u2010polio enteroviruses, termed acute flaccid myelitis (<jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content>). Outside these clusters, in countries where polio is not endemic, this poliomyelitic\u2010like illness is rare in childhood and its natural history is not well defined. We describe presenting features, investigation findings and long\u2010term outcome of a series of children with <jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight children (six females) aged 3 months to 8 years (median age 5 years) met case criteria. Initial symptoms were pain (<jats:italic>n<\/jats:italic> = 7) followed by limb weakness with hypotonia (<jats:italic>n<\/jats:italic> = 8). Flaccid paralysis occurred in only three patients. Two had cranial nerve dysfunction. Magnetic resonance imaging of the spinal cord demonstrated grey matter involvement particularly affecting the anterior cord, with longitudinally extensive changes in three children. Cerebrospinal fluid examination showed pleocytosis in six children with raised cerebrospinal fluid protein in five. Nerve conduction and electromyography findings were consistent with a motor neuronopathy. Residual deficits were common, with moderate to severe weakness seen in five patients. Median follow\u2010up was 28 months (range 17\u2013108 months, 30.4 patient years in total).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Acute flaccid myelitis is an uncommon condition in childhood with a high rate of significant long\u2010term morbidity. <jats:styled-content style=\"fixed-case\">AFM<\/jats:styled-content> should be considered in children presenting with acute limb pain and weakness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13345","type":"journal-article","created":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T06:46:50Z","timestamp":1498114010000},"page":"1077-1083","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Acute flaccid myelitis in childhood: a retrospective cohort study"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8489-4368","authenticated-orcid":false,"given":"E. W.","family":"Andersen","sequence":"first","affiliation":[{"name":"Department of Neurology The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Department of Paediatrics and Child Health University of Otago Wellington Wellington New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Kornberg","sequence":"additional","affiliation":[{"name":"Department of Neurology The Royal Children's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. L.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Neurology The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Murdoch Children's Research Institute Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. J.","family":"Leventer","sequence":"additional","affiliation":[{"name":"Department of Neurology The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Murdoch Children's Research Institute Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Neurology The Royal Children's Hospital Melbourne Victoria Australia"},{"name":"Murdoch Children's Research Institute Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.10.007"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62457-0"},{"key":"e_1_2_7_4_1","unstructured":"SejvarJ PastulaD CorteseM et al.Acute flaccid myelitis: interim considerations for clinical management. Atlanta GA: US Department of Health and Human Services CDC.2014.http:\/\/www.cdc.gov\/acute-flaccid-myelitis\/downloads\/acute-flaccid-myelitis.pdf(accessed 21\/09\/2016)."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.4388"},{"key":"e_1_2_7_6_1","unstructured":"CDC.Case definition of AFM.2016.http:\/\/www.cdc.gov\/acute-flaccid-myelitis\/hcp\/case-definition.html(accessed 21\/09\/2016)."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2008.00182.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1085-9489.2005.0010206.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909233411302"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.71.2.272"},{"key":"e_1_2_7_11_1","first-page":"9","article-title":"Use of corticosteroids in acute stages of poliomyelitis and in other neuroinfections","volume":"1","author":"Bogdanov IL","year":"1962","journal-title":"Pediatr Akus Ginekol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-7158.1952.tb13108.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000066810.62490.FF"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2012.00037"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-014-2233-x"},{"key":"e_1_2_7_16_1","first-page":"273","article-title":"A new syndrome: poliomyelitis\u2010like illness associated with acute asthma in childhood","volume":"10","author":"Hopkins IJ","year":"1974","journal-title":"Aust Paediatr J"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(95)00181-E"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2009.09.013"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000113"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.13345","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T08:09:19Z","timestamp":1695542959000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.13345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,22]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1111\/ene.13345"],"URL":"https:\/\/doi.org\/10.1111\/ene.13345","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,22]]},"assertion":[{"value":"2016-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}