About 10 days after what seemed like a garden-variety cold, Luca Waugh, a healthy 4-year-old, developed troubling symptoms.

Suddenly, his neck became so weak that he fell backward. Then his right arm couldn’t move. Within days, recalled his mother, Dr. Riley Bove, he developed “head-to-toe paralysis, where he could kind of move his eyes a little bit and one side of his face.”

Doctors diagnosed Luca with acute flaccid myelitis, or AFM, a mysterious neurological condition that can cause limb weakness and poliolike paralysis, mostly in young children. AFM is rare, but in 2014, when Luca became afflicted, health authorities identified a burst of 120 cases. Since then, AFM has made headlines as cases have spiked every two years, and nearly 600 have been confirmed across the country since 2014.

What causes AFM has eluded experts, frustrating attempts to prevent or treat it.

Now, a study by a team that includes Luca’s mother, Bove, a neurologist, provides strong evidence of a likely cause. It involved dozens of children with AFM, including Luca, whose paralysis improved after weeks of hospitalization but who remains disabled five years later.

The research, published Monday in the journal Nature Medicine, points to a long-suspected culprit: enteroviruses, a group of common viruses that usually produce mild effects but can sometimes cause neurological symptoms. Using sophisticated laboratory techniques, researchers found antibodies to enteroviruses in the cerebrospinal fluid of nearly 70% of the children with AFM, a sign their bodies had mobilized to defend against enterovirus infection.

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