AIM We aim to describe the demographic characteristics, etiology, neurophysiology, imaging findings, treatment, prognosis, and prognostic factors of acute flaccid myelitis. METHODS The clinical data, laboratory test and, magnetic resonance imaging (MRI) results of pediatric patients diagnosed with acute flaccid myelitis according to the Centers for Disease Control criteria between August 1, 2016, and December 31, 2018, from 13 centers in Turkey were reviewed. RESULTS Of the 34 cases identified, 31 were confirmed (91.2%). Eighteen patients (55.9%) were boys. The median patient age was 4 years (interquartile range 2.5-6.9 years). Most of the patients were admitted in 2018 (n = 27). A preceding history of a febrile illness was reported in all patients, with a median of 4 days (interquartile range 3-7 days) before symptom onset. Thirty-one patients had T2 hyperintensity on spinal MRI, and 18 patients had cerebrospinal fluid pleocytosis. The most common infectious agents were entero/rhinoviruses (n = 5) in respiratory specimens. All patients except one received immunotherapy either alone or in combination. Among 27 patients with follow-up data 24 had persistent weakness. Involvement of four limbs together with an abnormal brain MRI at onset were associated with a poor prognosis. CONCLUSION The number of patients with acute flaccid myelitis increased since 2012, spiking with every 2-year interval, largely in the pediatric population. The median age decreases with every outbreak. Clinicians should be aware of the clinical picture for early collection of specimens and early start of rehabilitation programs. Further studies are needed to better characterize the etiology, pathogenesis, risk factors, and treatment of this rare condition.

中文翻译：

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2016-2018 年急性弛缓性脊髓炎暴发：来自土耳其的多中心经验

目的 我们旨在描述急性弛缓性脊髓炎的人口学特征、病因、神经生理学、影像学表现、治疗、预后和预后因素。方法 2016 年 8 月 1 日至 2018 年 12 月 31 日期间，土耳其 13 个中心根据疾病控制中心标准诊断为急性弛缓性脊髓炎的儿科患者的临床资料、实验室检查和磁共振成像 (MRI) 结果为审查。结果 在确定的 34 例病例中，确诊 31 例（91.2%）。18 名患者 (55.9%) 是男孩。中位患者年龄为 4 岁（四分位距为 2.5-6.9 岁）。大多数患者于 2018 年入院（n = 27）。所有患者均报告有发热病史，症状出现前的中位时间为 4 天（四分位距为 3-7 天）。31 名患者在脊髓 MRI 上有 T2 高信号，18 名患者有脑脊液细胞增多症。呼吸道标本中最常见的传染源是肠道/鼻病毒（n = 5）。除一名患者外，所有患者均接受单独或联合免疫治疗。在有随访数据的 27 名患者中，24 名持续虚弱。四肢受累以及发病时脑部 MRI 异常与预后不良有关。结论 急性弛缓性脊髓炎患者的数量自 2012 年以来有所增加，每 2 年增加一次，主要是在儿科人群中。每次爆发时，中位年龄都会下降。临床医生应该了解早期标本采集和康复计划早期启动的临床情况。需要进一步研究以更好地描述病因，