Acute Flaccid Myelitis.

Acute flaccid myelitis (AFM) is an incompletely understood neurologic disorder occurring in epidemic fashion causing weakness ranging from mild paresis to devastating paralysis in children and some adults. This article reviews the case definition of AFM as well as its epidemiology and association with enteroviral infection. The clinical presentation, diagnostic investigation with particular attention to electrodiagnostics, acute management, and surgical options are described. Clinical outcomes and considerations for acute and long-term rehabilitation management are discussed extensively based on review of current literature, highlighting avenues for further study.

Telehealth in pediatric rehabilitation medicine: A survey of clinician reported utilization and experience.

PURPOSE: Telehealth services have been touted to improve access to specialty pediatric care. COVID-19 accelerated the adoption of telehealth across many medical specialties. The purpose of this study was to examine telehealth utilization and satisfaction among pediatric physiatrists. METHODS: Using Google Forms, a voluntary survey was created and administered to pediatric physiatrists. The survey collected information on practice setting, telehealth utilization, provider satisfaction, perceived satisfaction of patients and families, and the anticipated role of telehealth in pediatric rehabilitation going forward. RESULTS: Seventy-eight respondents completed the survey. There was a significant reported increase in telehealth utilization since COVID-19 from 14.5% to 97.4%. Eighty-two percent of participants reported feeling comfortable utilizing telehealth, 77% felt confident in the quality of the care provided, and 91% believed patients were satisfied with telehealth visits. Responses indicate that telehealth is expected to play a role in future pediatric physiatry and interest in telehealth continuing medical education is prevalent. Most pediatric physiatrists plan to continue or expand telehealth offerings after COVID-19. CONCLUSION: Telehealth adoption has been expedited by COVID-19. Physician interest in and satisfaction with telehealth is high. Patient and family perceptions, outcomes of care, and barriers to implementation limiting program expansion deserve further study.

Central serous chorioretinopathy following hypobaric chamber exposure.

BACKGROUND: Hypobaric hypoxic exposures are associated with a number of risks, most notably decompression sickness and various ophthalmologic disorders, including high altitude retinopathy. Central serous chorioretinopathy (CSCR) is an idiopathic condition that typically affects young males and is associated with several comorbidities and medications; however, an association with hypoxia or high altitude has not been identified. We present a case of CSCR in an aviator following a simulated flight in a hypobaric chamber. CASE REPORT: A 30-yr-old male U.S. Navy pilot presented with complaints of painless unilateral scotoma, micropsia, and blurred vision 1 h after completing a training exercise in a hypobaric chamber. A dilated fundoscopic examination, macular optical coherence tomography, and intravenous fluorescein angiography confirmed a diagnosis of CSCR. The patient was restricted from flying duty and observed for a period of 1 mo, after which point his symptoms spontaneously resolved and flight status was restored. DISCUSSION: Complaints of visual symptoms immediately following hypobaric exposure should primarily trigger suspicion of decompression sickness; however, once ruled out, patients should be referred to an eye specialist for detailed ocular examination. This case suggests a possible link between CSCR and hypobaric hypoxia as a topic of further investigation.