Guidance

Acute flaccid paralysis (AFP): Information for patients

Updated 14 November 2022

Applies to England

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This publication is available at https://www.gov.uk/government/publications/acute-flaccid-paralysis-information-for-patients/acute-flaccid-paralysis-afp-information-for-patients

Overview of acute flaccid paralysis

Acute flaccid paralysis (AFP) is a set of symptoms which are often associated with a condition called acute flaccid myelitis (AFM). AFM is not a new condition. AFP affects the nervous system, specifically the spinal cord, causing one or more of the limbs to become weak or floppy (flaccid). It is rare but serious and tends to particularly, though not exclusively, affect children.

If you or your child develops any symptoms of AFP or AFM seek medical care. They may refer you to a hospital specialist for more tests if they’re unsure what’s causing your symptoms.

Symptoms of AFP or AFM

Most people will experience weakness in the arm(s) or leg(s) and loss of muscle tone and reflexes which come on suddenly. People may also have:

  • facial droop or weakness
  • difficulty moving the eyes
  • drooping eyelids
  • difficulty swallowing or slurred speech

In some cases people may experience other rarer symptoms including:

  • numbness or tingling, but this is rare
  • pain in their arms or legs
  • inability to pass urine (pee)

In severe cases AFP can lead to respiratory failure (as the muscles involved with breathing become weak) or other serious neurological complications.

Diagnosis of AFP or AFM

AFP or AFM can be difficult to diagnose because it shares many of the same symptoms as other neurological diseases. Doctors will typically examine a patient’s nervous system and look at images of the spinal cord and brain. They can also test the fluid around the brain and spinal cord and may check the nervous system conduction.

Causes of AFP or AFM

Certain viruses are known to cause AFP or AFM including poliovirus and non-polio enterovirus. One particular enterovirus, EV-D68, does circulate widely in the UK and in other countries. It can, very rarely, be associated with acute respiratory infection and has been linked to acute polio-like symptoms. EV-D68 has been detected in a small number of AFP or AFM cases so far. The last case of wild polio contracted in the UK was confirmed in 1984. The UK was declared polio-free in 2003.

Respiratory illnesses and fever from viral infections are common, especially in children, and most people recover. The risks of such neurological symptoms due to EV-D68, and other viruses, in the UK are considered to be extremely low.

Treatment of AFP or AFM

There is no specific treatment for AFP, but a specialist doctor (neurologist) may recommend certain therapies, such as physical or occupational therapy, on a case-by-case basis to help with arm or leg weakness.

Prevention of AFP or AFM

There is no specific action you can take to prevent AFP or AFM but as certain viruses are known to cause AFP or AFM you can protect yourself and others by:

  • getting vaccinated to protect yourself against polio. Polio vaccine contains inactivated (not live) virus, and protects against poliovirus. This vaccine does not protect against other viruses that may cause AFP or AFM

  • washing your hands frequently with soap and water, avoiding close contact with people who are sick, and cleaning and disinfecting frequently touched surfaces, including toys

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