There’s ever growing concern about the polio-like illness that hit a record number of cases among children in 2018.
It starts as a cold or flu in children and leads to paralysis — it’s called acute flaccid myelitis. One local family reached out to 10 On Your Side with many questions after their daughter ended up in the hospital.
They say she had similar symptoms — like slurred speech, muscle weakness, and paralysis but Dehaviland Evans, 8, was diagnosed with a different form of myelitis.
It is called acute disseminated encephalomyelitis or ADEM. Doctors say disseminated encephalomyelitis (ADEM) is a brief but intense attack of inflammation (swelling) in the brain and spinal cord and occasionally the optic nerves that damages the brain’s myelin.
The Evans family reached out because Dehaviland was dancing one minute and unable to walk, talk or eat the next.
“We heard a poodoop, we were woken up by a bump and we woke up and she was on the floor,” said Evans.
“As a mother, I wish I could trade places with her, just watching her, it’s hurtful,” said Dehaviland’s mother, Lakisha Wyche.
With so much media coverage of acute flaccid myelitis, or AFM, the polio-like virus that attacks the spinal cord and remains a bit of a mystery — this family questioned if their daughter was another case.
10 On Your Side spoke with Doctor Michael Strunc, who is treating Dehaviland for ADEM at the Children’s Hospital of the King’s Daughters.
“ADEM is similar to other central nervous system demylinating disorders and that is a group of disorders that is what most people know in adults as multiple sclerosis, but it all starts with a common virus,” said Dr. Strunc. “So, let’s say everyone in the community gets this virus [common cold] or illness and one child in this whole region gets this disorder. We sort of know how to treat this and attack it which is to attack the inflammation of the spinal cord.”
Doctor Strunc says there is not a mystery surrounded ADEM as with AFM, and doctors know how to treat it with steroids. He says in most cases, this is a one-time event and kids recover fully.
As for Dehaviland, her parents are devastated that something that started as a cold could lead to several stays at the hospital for their daughter.
“Even though it may be a cold, I would recommend to keep a close watch on them. Once again, my daughter had a common cold and it turned out to be something totally different,” Evans said.
According to the Multiple Sclorosis Society:
Acute Disseminated Encephalomyelitis (ADEM) is a brief but intense attack of inflammation (swelling) in the brain and spinal cord and occasionally the optic nerves that damages the brain’s myelin (the white coating of nerve fibers). Other terms used to refer to ADEM include post-infectious encephalomyelitis and immune-mediated encephalomyelitis.
ADEM is sometimes difficult to distinguish from multiple sclerosis (MS) because the symptoms common to both “demyelinating” disorders include loss of vision, weakness, numbness and loss of balance. Both ADEM and MS involve immune-mediated responses to myelin in the brain and spinal cord.
What causes ADEM?
The cause of ADEM is not clear but in more than half of the cases, symptoms appear following a viral or bacterial infection, usually a sore throat or cough and very rarely following vaccination. ADEM is thought to be an autoimmune condition where the body’s immune system mistakenly identifies its own healthy cells and tissues as foreign and mounts an attack against them. This attack results in inflammation. Most cases of ADEM begin about 7 to 14 days after an infection or up to three months following a vaccination. In some cases of ADEM, no preceding event is identified.
According to the Centers for Disease Control:
Acute flaccid myelitis (AFM) is a rare but serious condition. It affects the nervous system, specifically the area of the spinal cord called gray matter, which causes the muscles and reflexes in the body to become weak. This condition is not new. However, the large number of AFM cases reported since 2014, when we first started our surveillance for this condition, is new. The risk of getting AFM varies by age and year. We have seen increases in AFM cases every two years since 2014 and mostly in young children. Still, CDC estimates that less than one to two in a million children in the United States will get AFM every year. We think viruses likely play a role in AFM. Since 2014, most patients (more than 90%) had a mild respiratory illness or fever consistent with a viral infection before they developed AFM. All the stool specimens from AFM patients that we received tested negative for poliovirus. We are working closely with national experts to better understand the possible causes of AFM and update our information on treatment.