| ID | 185 |
|---|---|
| Name | POLIOMYELITIS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis: 1. CSF shows- - lymphocytosis - rise in protein 50-100 gm% with - normal sugar level. - increased cells, initially polymorphs followed by lymphocytes 50-400/cmm 2. Virus may be isolated from throat washing in the early stages and from stool in late stage as well as in early stage. 3. CFT may be positive during the second week. |
| Investigations | |
| Management | |
| Introduction | This is an acute infective disease caused by poliovirus (a subdivision of the group of entero-viruses) and usually occur through the nasopharynx. The virus affects the grey matter of the spinal cord, brain stem and cortex and has a particular propensity to damage anterior horn cells specially those within the lumber segment. The incubation period is 7-14 days. |
| History | |
| Etiology | |
| Clinical Features | Clinical features: There are various clinical types- Abortive poliomyelitis: Some cases of poliomyelitis may have recovery after initial symptoms of fever, headache, sore-throat, vomiting, diarrhoea and constipation. Non-paralytic poliomyelitis: Apart from symptoms mentioned above, muscle spasm of the neck and back. There may be tenderness of the muscles. Straight leg rising is positive. No paralysis occurs in this variety. Paralytic poliomyelitis: Paralysis is almost always symmetrical and scattered. Lower limbs are more frequently affected than the upper and trunk. Reflexes are lost. Sensory loss is rare. Bulbar paralysis may develop and paralysis of respiratory muscles is the most dangerous complication. Asymptomatic poliomyelitis: This refers to alimentery invasion without viremia. The virus can be demonstrated in the stools |
| Preventions | Prevention- Oral polio vaccine 2-3 drops by mouth is to be given within 6 weeks to 6 months in 1 month interval for 3 dosages (see immunization schedule). Other causes of acute paralytic disease - 1. Spinal trauma. 2. Spinal neoplasm. 3. Bites or stings ( Snake venom). 4. Chemical poisons (e.g Arsenic). 5. Guillain-Barre syndrome. 6. Viral infection (e.g coxsackie virus, enterovirus). |
| Treatment | Treatment: Curative - There is no specific treatment available to date. General measures include- 1. Hospitalization of all cases of paralytic polio. 2. Strict bed rest. 3. Minimal handling of the affected parts. Neutral position of the limbs 4. Analgesics & mild sedatives for releif of pain. 5. Attention to solving problems like retention of urine and constipation. 6. Maintenance of adequate fluid and dietetics. 7. Suction to remove secretions from throat. 8. Tracheostomy may be required when there is constriction of the hypopharynx ( rope sign). 9. When the child is free from muscle pain, physiotherapy and progressive rehabilitation should be started. |
| Complications | |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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