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Acute Flaccid Myelitis — Imaging — Clinical Pathway: Emergency and Inpatient

Evaluation of Suspected Acute Flaccid Myelitis Clinical Pathway — Emergency and Inpatient

Imaging

Neuroimaging

Discuss imaging needs with Neurology and Neuroradiology

MRI ideally completed within 12 hours of presentation

MRI Spine
  • Order level-appropriate spine MRI as soon as able
MRI Brain
  • Consider if:
    • Altered mental status
    • Negative spine MRI
Sedation
  • > 48 Hours of Clinical Findings without Progression
  • Consider without sedation due to high risk of loss of airway function due to the rapidly progressive nature of AFM
    • Assessment by Sedation Team
    • Consult Anesthesia Team as needed
    • Consider Child Life assessment
  •  
  • ≤ 48 Hours of Clinical Findings or Concern for Progressive Symptoms, Bulbar or Cranial Nerve Dysfunction, Cervical Lesions, or Abnormal NIF
    • Admit to PICU
    • Sedation by PICU or Anesthesia Team

 

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