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Spinal Paralytic Poliomyelitis
Acute Paralyt Non Bulbar Polio

Presentation

[…] with tight neck, back & hamstring mm; transient paresis; (+) meningeal irritation; lab findings: increase protein in CSF involves the CNS; presents with asymmetrical weakness; urinary retention; constipation; cardiac arrythmias; mm soreness; headache [quizlet.com]

Poliomyelitis is a ubiquitous, highly contagious, seasonal disease presenting during the rainy season or summer months. [clinicaladvisor.com]

These cytologic changes were not present in monkeys sacrificed in still later stages of the disease. 5. [jem.rupress.org]

This is a 4-1/2 month old female who presents to the ER with weakness in her right leg. She is afebrile and does not appear to have any difficulty breathing. [hawaii.edu]

VACCINE-ASSOCIATED PARALYTIC POLIOMYELITIS IN RUSSIAN FEDERATION DURING THE PERIOD OF CHANGES IN VACCINATION SCHEDULE (2006-2013 yy.)]. ( 27145594 ) Ivanova O.E....Kozlovskaja L.I. 2016 11 Vaccine associated paralytic poliomyelitis cases from children presenting [malacards.org]

Respiratoric

  • Nasal Voice

    Dysphagia, nasal regurgitation, and nasal voice are usually the earliest signs of bulbar involvement, but some patients have pharyngeal paralysis and cannot control oral secretions. [merckmanuals.com]

Gastrointestinal

  • Regurgitation

    Dysphagia, nasal regurgitation, and nasal voice are usually the earliest signs of bulbar involvement, but some patients have pharyngeal paralysis and cannot control oral secretions. [merckmanuals.com]

    There is dysphagia, dysarthria, regurgitation of fluids down the nose. Laryngeal paralysis may be partial or complete. Facial paralysis may develop. Ocular palsies are not common. Nystagmus occurs in short bursts and at rapid rhythm. [healthdrip.com]

    In two percent of paralytic cases, infection damages cranial nerves and the reticular formation in the brain stem resulting in a variety of problems: inability to spit, dysphagia, dysphonia, difficulty in chewing and regurgitation of food. [microbewiki.kenyon.edu]

    This type of paralysis can lead to the regurgitation of the gastric juices into the respiratory system thus causing it to shut down. The large majority of these cases (80%) can still recover through proper treatment. [encyclopedia.com]

Cardiovascular

  • Thrombosis

    During active myelitis, precautions to avoid complications of bed rest (eg, deep venous thrombosis, atelectasis, UTI) and prolonged immobility (eg, contractures) may be necessary. Respiratory failure may require mechanical ventilation. [merckmanuals.com]

  • Hypotension

    This may cause autonomic features - eg, hyper/hypotension, respiratory failure, and bulbar symptoms, such as dysphagia and dysphonia. Rarely, acute encephalitis can occur from poliovirus. [patient.info]

Musculoskeletal

  • Muscle Weakness

    Muscle weakness Other names Myasthenia Specialty Neurology Muscle weakness is a lack of muscle strength. Its causes are many and can be divided into conditions that have either true or perceived muscle weakness. [en.wikipedia.org]

    Although EV-D68 genetics now more closely resemble poliovirus, it’s not clear that the virus directly causes muscle weakness and paralysis (as polio does). [wired.com]

    About four to five percent of infected people have minor symptoms such as fever, muscle weakness, headache, nausea and vomiting. One to two percent of infected persons develop severe muscle pain and stiffness in the neck and back. [health.ny.gov]

    Symptoms include tiredness, new muscle weakness, and muscle and joint pain. There is no way to prevent or cure PPS. The polio vaccine has wiped out polio in the United States and most other countries. [icdlist.com]

  • Muscle Spasm

    It is characterized by: back pain muscle stiffness headache fatigue irritability diarrhea pain over the calf muscles mild to moderate fever muscle spasm and pain neck pain and stiffness pain in front of the neck or in the back, arms, abdomen and legs [news-medical.net]

    Controlling pain and muscle spasms and watching for progression of muscle weakness so supportive care can be given are the main parts of treatment. [humanillnesses.com]

    Muscular complications include muscle contractions or muscle spasms in the calf, neck, or back, muscle pain, muscle weakness that is only on one side or worse on one side. The location of this pain depends on where the spinal cord is affected. [wikilectures.eu]

    Common manifestations of paralytic poliomyelitis in addition to aseptic meningitis include deep muscle pain, hyperesthesias, paresthesias, and, during active myelitis, urinary retention and muscle spasms. [merckmanuals.com]

    Applications of heat in the form of hot wet packs, diathermy, warm baths in the form of hydrotherapy, and gentle exercising can reduce pain caused by muscle spasms and prevent deformities. [medical-dictionary.thefreedictionary.com]

Urogenital

  • Urinary Retention

    retention; constipation; cardiac arrythmias; mm soreness; headache; paresthesias; (+) meningeal irritation most frequent ; cervical, thoracic & lumbar segments are involved - most severe; presents with facial weakness; dysphagia; dyspnea bulbospinal [quizlet.com]

    Common manifestations of paralytic poliomyelitis in addition to aseptic meningitis include deep muscle pain, hyperesthesias, paresthesias, and, during active myelitis, urinary retention and muscle spasms. [merckmanuals.com]

    retention. v Stiffness and pain in the neck and back because of meningeal irritation, as well as abnormalities of autonomic function, also can be seen in some patients. v Cranial nerve involvement o Approximately 10-15% of cases affect the lower brainstem [sites.google.com]

Neurologic

  • Flaccid Paralysis

    Asymmetric flaccid paralysis may develop and progress over 2 to 3 days. Encephalitic signs occasionally predominate. [merckmanuals.com]

    If poliovirus is isolated from a patient experiencing acute flaccid paralysis, it is further tested through oligonucleotide mapping (genetic fingerprinting). [rotary5790.org]

    Magnetic Resonance Imaging (MRI) could be helpful to exclude other causes of acute flaccid paralysis. [clinicaladvisor.com]

    […] and respiratory paralysis Etiology Viral, in particular poliovirus, but also coxsackie A7, enterovirus 71, and others Clinical If extreme, asymmetric flaccid paralysis Lab CSF pleocytosis, ↑ lymphocytes. [medical-dictionary.thefreedictionary.com]

  • Paresthesia

    Symptoms are fever, severe headache, stiff neck and back, deep muscle pain, and sometimes areas of hyperesthesia (increased sensation) and paresthesia (altered sensation). [medicinenet.com]

    […] with tight neck, back & hamstring mm; transient paresis; (+) meningeal irritation; lab findings: increase protein in CSF involves the CNS; presents with asymmetrical weakness; urinary retention; constipation; cardiac arrythmias; mm soreness; headache; paresthesias [quizlet.com]

    These symptoms include: Paresthesia: Feeling of pins and needles in the legs or arms. Meningitis : Infection of the coverings around the brain and spinal cord. Paralysis: Absent or reduced ability to move the legs, arms, and/ or breathing muscles. [my.clevelandclinic.org]

    […] presentation is similar to non- paralytic polio later progress to more serious symptoms such as: a loss of muscle reflexes severe muscle pain and spasms loose or floppy limbs that are often worse on one side of the body loss of superficial and deep reflexes, paresthesia [medcaretips.com]

    Common manifestations of paralytic poliomyelitis in addition to aseptic meningitis include deep muscle pain, hyperesthesias, paresthesias, and, during active myelitis, urinary retention and muscle spasms. [merckmanuals.com]

  • Guillain-Barré Syndrome

    Guillain-Barré syndrome causes flaccid paralysis but can be distinguished because of the following: It usually causes no fever. Muscle weakness is symmetric. [merckmanuals.com]

    Other causes of acute flaccid paralysis - eg: Various infections Guillain-Barré syndrome Spinal cord lesions Neuropathies Myasthenia gravis Myopathy or myositis Investigations Serology: take acute and convalescent samples. [patient.info]

    Ropper, "Nonpoliovirus poliomyelitis simulating Guillain-Barré syndrome," Archives of Neurology 58(2001)iss. 9: 1460–4. PMID 11559319. Retrieved February 19, 2011. ↑ 23.0 23.1 23.2 23.3 23.4 V. Racaniello and D. [newworldencyclopedia.org]

    "Nonpoliovirus poliomyelitis simulating Guillain–Barré syndrome". Archives of Neurology. 58 (9): 1460–64. doi : 10.1001/archneur.58.9.1460. PMID 11559319. Archived from the original on 19 April 2013. ^ a b Parker SP, ed. (1998). [en.wikipedia.org]

  • Limb Weakness

    Also, cases of focal limb weakness or paralysis have been identified after infection with enterovirus D68. [merckmanuals.com]

    Your doctor may suspect that you have polio if you have fever with limb weakness or paralysis that mainly affects one side of your body. [drugs.com]

    No progression of weakness should be noted after the temperature drops to normal for 48 hours. Weakness is asymmetric, with the lower limbs affected more than upper limbs. [sites.google.com]

  • Lower Motor Neurone Lesion

    3 weeks) flu-like illness; 1:10 develop lower motor neurone lesions (paralysis of skeletal muscles subserved by affected spinal nerves), muscle atrophy and soft-tissue contracture with resultant limb/foot deformity (e.g. fixed equinovarus or calcaneovalgus [medical-dictionary.thefreedictionary.com]

    Differentiation between a central (upper motor neuron), and peripheral (lower motor neuron) lesion is the first step in determining the extent of the disease. [clinicaladvisor.com]

Workup

If CSF is obtained in the workup, it rarely isolates the poliovirus, but it can demonstrate pleocytosis with mildly elevated protein. [hawaii.edu]

X-Ray

  • Atelectasis

    During active myelitis, precautions to avoid complications of bed rest (eg, deep venous thrombosis, atelectasis, UTI) and prolonged immobility (eg, contractures) may be necessary. Respiratory failure may require mechanical ventilation. [merckmanuals.com]

    Chest physical therapy (CPT) helps patients with bulbar involvement prevent any pulmonary complications, such as atelectasis. Frequent repositioning of paralyzed patients helps to prevent bedsores. [sites.google.com]

Treatment

There is no medicine to cure the virus, but treatment is done to help aid a child’s comfort and recovery from the virus. This is called supportive treatment. [elcaminohospital.org]

Treatment. There is at present no cure for polio; once the disease begins it must be allowed to run its course. Supportive care is important, however, and proper symptomatic treatment can reduce discomfort and prevent some crippling aftereffects. [medical-dictionary.thefreedictionary.com]

Treatment is supportive. This means that the symptoms may be treated to improve your child's comfort and recovery. [vidanthealth.com]

Treatment and prognosis In the modern Western world, poliomyelitis is prevented by vaccination. As no cure for poliomyelitis itself is available, treatment is supportive and designed to prevent complications and a quick recovery. [radiopaedia.org]

Prognosis

Prognosis depends on the extent of motor neuron destruction by the time treatment is started and varies from complete recovery to severely debilitating paralysis 7. [radiopaedia.org]

PROGNOSISPROGNOSIS  Inapparent, abortive polio and asepticInapparent, abortive polio and aseptic meningitis have good prognosis with nomeningitis have good prognosis with no long-term sequel.long-term sequel.  Mortality rate in severe bulbar polio is [slideshare.net]

Prognosis [ ✎ edit | edit source ] Permanent weakness is observed in about two out of three patients affected with paralytic poliomyelitis. [wikilectures.eu]

Prognosis [ 3 ] The milder spectrum of poliovirus infection (asymptomatic or flu-like illness only) carries no specific complications. With paralytic polio, muscle function may return gradually. [patient.info]

Etiology

What does the name Polio and myelos mean How is poliomyelitis characterized by the destruction of the anterior horn cells of the spinal cord there are ___ human poliovirus serotypes what is the etiological agent of Polio describe the etiological agent [brainscape.com]

Poliomyelitis By Michael Plunkett Disease/Etiologic Agent: Poliomyelitis (5); Family: Picornaviridae (5); 3 known serotypes are P1, P2, and P3 (5) Transmission: It is spread mainly through oral and fecal contact, whether this is through the not washing [austincc.edu]

[…] grey matter. (2) Acute anterior poliomyelitis. poliomyelitis Neurology A condition characterized by the selective destruction of anterior horn cells in the spinal cord and/or brain stem, ± leading to muscle weakness, paralysis and respiratory paralysis Etiology [medical-dictionary.thefreedictionary.com]

Ongoing controversies regarding etiology, diagnosis, treatment During 2000 and 2001, an outbreak of 21 cases of paralytic poliomyelitis on the island of Hispaniola occurred, caused by a virulent strain genetically related to the type 1 Sabin OPV vaccine [clinicaladvisor.com]

Epidemiology

Role of epidemiology in vaccine policy. Vaccine, Vol. 8, Issue. 3, p. 180. CrossRef Google Scholar Dittmann, S. 1990. Vol. 14, Issue., p. 267. [cambridge.org]

[…] flaccid paralysis in Uganda. ( 26058454 ) Nanteza M.B....Bwogi J. 2015 12 Vaccine-associated paralytic poliomyelitis: a case report. ( 24647260 ) Ilic M.D....Obradovic S.D. 2014 13 Outbreaks of paralytic poliomyelitis during 1996-2012: the changing epidemiology [malacards.org]

Based upon an epidemiological model representing a population of 200,000 within a developing country, the estimated basic reproductive number of wild polio infection is 12. [sphweb.bumc.bu.edu]

European Journal of Epidemiology 2000;16:601-6. 11. John TJ. Anomalous observations on IPV and OPV vaccination. Developments in Biologicals 2001;105:197-208. 12. WHO Consultative Group. [scielosp.org]

Epidemiology and Prevention of Vaccine-Preventable Diseases. Poliomyelitis. (512 KB). Atkinson, W., Wolfe, S., Hamborsky, J., McIntyre, L., eds. 13th ed. Washington DC: Public Health Foundation, 2015. Accessed 01/25/2018. [historyofvaccines.org]

Pathophysiology

[…] stranded RNA; belongs to the enterovirus group of the picornavirus family; has an affinity for motor neurons type I of Polio virus most frequent & most severe type II of Polio virus; next most frequent type III of Polio virus; least frequent & severe PATHOPHYSIOLOGY [quizlet.com]

A girl with deformity in right lower limb after polio, non copyrighted image from Wikipedia Pathophysiology of Polio Poliovirus is a type of enterovirus, a group of RNA viruses that colonize the gastrointestinal tract. [medcaretips.com]

Pathophysiology Acute poliomyelitis is caused by small ribonucleic acid ( RNA ) viruses of the enterovirus group of the picornavirus family. [sites.google.com]

Parallels between post-polio fatigue and chronic fatigue syndrome: a common pathophysiology? Am J Med. 1998 Sep 28;105(3A):66S-73S. PMID: 9790485; UI: 99005146. Similarity of polio to pellagra, beriberi, and other deficiency diseases--Eleanor McBean [whale.to]

[citation needed] Pathophysiology[edit] Muscle cells work by detecting a flow of electrical impulses from the brain which signals them to contract through the release of calcium by the sarcoplasmic reticulum. [en.wikipedia.org]

Prevention

Centers for Disease Control and Prevention Polio: Information for Parents (American Academy of Family Physicians) Polio: Information for Parents (American Academy of Pediatrics) Polio: Information for Parents (Centers for Disease Control and Prevention [icdlist.com]

Through vaccination, the disease is preventable. [medical-dictionary.thefreedictionary.com]

Source Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Poliomyelitis. (512 KB). Atkinson, W., Wolfe, S., Hamborsky, J., McIntyre, L., eds. 13th ed. [historyofvaccines.org]

Treatment and prognosis In the modern Western world, poliomyelitis is prevented by vaccination. As no cure for poliomyelitis itself is available, treatment is supportive and designed to prevent complications and a quick recovery. [radiopaedia.org]

Centers for Disease Control and Prevention, Atlanta, GA 30333 [nejm.org]

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