Etiological spectrum and management of children and adolescents diagnosed with acute flaccid paralysis: Experience from a tertiary care center

Aim: This study aimed to evaluate the demographic, clinical, laboratory, radiological, and electrophysiological characteristics of pediatric and adolescent patients who were followed with a diagnosis of acute flaccid paralysis (AFP) in a tertiary healthcare center; to determine the etiological spectrum; and to examine the treatment approaches used in patient management. Materials and Methods: This retrospective cross-sectional study included a total of 36 patients who were followed between 2015 and 2025 in the pediatrics and pediatric neurology departments of a tertiary university hospital with a diagnosis of AFP. Data on patients' age, sex, birth history, previous infections, clinical findings, laboratory results, magnetic resonance imaging (MRI) and electromyography (EMG) findings, as well as treatments applied and follow-up outcomes, were obtained retrospectively from patient files. Descriptive statistical analyses were performed, and when appropriate, the Mann–Whitney U test and Fisher's Exact test were used for comparisons. Results: The mean age of the 36 patients included in the study was 8.08 ± 4.75 years, and 69.4% were male. The most common presenting symptom was muscle weakness (97.2%), followed by pain (52.8%) and sensory loss (25%). MRI findings were abnormal in 63.9% of the cases. Among 35 patients who underwent EMG, 57.1% had pathological findings. Intravenous immunoglobulin (IVIG) was administered to 83.3% of patients, steroids to 27.7%, and plasmapheresis to 8.3%. The overall treatment response rate was 91.7%. At the 12-month follow-up, neurological examination findings had completely normalized in 88.9% of the patients. Comparison of GBS subtypes revealed no statistically significant difference between the AIDP and AMAN groups in terms of demographic or clinical parameters (p > 0.05). Conclusion: Acute flaccid paralysis in childhood presents a broad etiological spectrum, and early diagnosis and appropriate treatment are of critical importance for prognosis. Comprehensive clinical, laboratory, and electrophysiological evaluations performed in tertiary centers enable accurate etiological differentiation, early initiation of treatment, and prevention of permanent neurological sequelae. This study provides up-to-date data on the epidemiological and clinical characteristics of AFP cases in our country and aims to serve as a guide for clinicians in patient management.