Peer-reviewed article

2330. Acute Flaccid Myelitis Recovery: Filling in the Gaps and Assessing Likelihood for Independent Living

Downey Quick R, Murphey D, Fernandez M, Russo S, Hauger S · 1 Oct 2019

Abstract

Abstract Background Reports of Acute Flaccid Myelitis (AFM) typically describe outcomes according to full recovery of strength and function. Full recovery rates remain low (20–30%), but most children with AFM show some degree of improvement. Data are lacking describing the ability of children with AFM to perform activities of daily living (ADL) needed to eventually live as independent adults. Methods This is telephone survey-based study of parents with children diagnosed with AFM in 2018 at a free-standing children’s hospital in Central Texas. The survey assesses the level of functional independence in areas of eating, bathing, dressing, toileting, and mobility. Cases diagnosed in 2018 were surveyed at 6 months from diagnosis. Results Four cases were diagnosed with AFM during the 2018 season. All four patients with AFM who were called to answer the survey consented to participation. Figure 1 shows degree of residual weakness and recovery in each area of ADL for all 4 patients. Despite residual weakness in half of the cases, three of the four cases had either no deficit or mild functional deficit in all areas of ADLs. One case continues to require moderate assistance in 4 areas of ADLS. Of note, this case was also the only case in the 2018 season with identified enterovirus D68 at our institution. None reported total deficit in any ADL. Conclusion In this sample significant functional deficits were seen in one of the four cases. This child continues to develop adaptive skills using stronger extremities to compensate for flaccid weakness. While the hope is always for full recovery, it is important to give parents a realistic picture of partial recovery and likelihood of independence. Given the success of the survey locally, we plan to expand the study to the Texas AFM Collaborative and prospectively survey cases diagnosed in 2018 every 6 months for a period of 2 years. Disclosures All authors: No reported disclosures.