{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T17:59:28Z","timestamp":1761674368672,"version":"3.40.5"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Acute flaccid myelitis (AFM) and transverse myelitis (TM) are serious conditions that may be difficult to differentiate, especially at onset of disease. In this study, we compared clinical features of pediatric AFM and TM and evaluated current diagnostic criteria, aiming to improve early and accurate diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two cohorts of children with enterovirus D68\u2010associated AFM and clinically diagnosed TM were compared regarding presenting clinical features, additional investigations, and outcome. Current diagnostic criteria for AFM and TM were applied to evaluate their specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Children with AFM (<jats:italic>n<\/jats:italic>\u2009=\u200921) compared to those with TM (<jats:italic>n<\/jats:italic>\u2009=\u200936) were younger (median 3 vs. 10\u2009years), more often had a prodromal illness (100% vs. 39%), predominant proximal weakness (69% vs. 17%), and hyporeflexia (100% vs. 44%), and less often had sensory deficits (0% vs. 81%), bowel and\/or bladder dysfunction (12% vs. 69%), and hyperreflexia (0% vs. 44%). On magnetic resonance imaging, brainstem involvement was more common in AFM (74% vs. 21%), whereas supratentorial abnormalities were only seen in TM (0% vs. 40%). When omitting the criterion of a sensory level, 11 of 15 (73%) children with AFM fulfilled the diagnostic criteria for TM. Of children with TM, four of 33 (12%) fulfilled the diagnostic criteria for probable\/definite AFM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although there is considerable overlap between AFM and TM in children, we found important early differentiating clinical and diagnostic features. Meeting diagnostic criteria for AFM in children with TM and vice versa underlines the importance of thorough clinical examination and early and accurate diagnostic studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15861","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T08:40:10Z","timestamp":1683880810000},"page":"2430-2441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of acute flaccid myelitis and transverse myelitis in children and evaluation of diagnostic criteria"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4022-6162","authenticated-orcid":false,"given":"Jelte","family":"Helfferich","sequence":"first","affiliation":[{"name":"Department of Neurology, University Medical Center Groningen University of Groningen  Groningen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7990-5894","authenticated-orcid":false,"given":"Arlette L.","family":"Bruijstens","sequence":"additional","affiliation":[{"name":"Department of Neurology Erasmus University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjolein","family":"Knoester","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen University of Groningen  Groningen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oebele F.","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Groningen University of Groningen  Groningen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinze F.","family":"Neuteboom","sequence":"additional","affiliation":[{"name":"Department of Neurology Erasmus University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the 2016 Enterovirus D68 Acute Flaccid Myelitis Working Group and the Dutch Study Group for Pediatric Multiple Sclerosis and Acute Disseminated Encephalomyelitis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32723-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002188"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30094-X"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.3.17-00310"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30632-2"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.60.4.730"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001179"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002820"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-019-0603-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15170"},{"key":"e_1_2_10_12_1","unstructured":"CDC.Acute Flaccid Myelitis \u2010 Case Definitions.2021. 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