Acute paralytic polio
INTRODUCTION:
- 2nd phase of the illness
- Spotty paralysis
- Asymmetric flaccid paralysis
- One leg most common followed by one arm
- Absent DTRs
- In Paralytic poliomyelitis Anterior horn cell & Autonomous nervous system are affected
- Paralytic poliomyelitis develops in about 1% patients causing 3 clinically recognizable syndromes which are
- Spinal paralytic poliomyelitis
- Bulbar poliomyelitis
- Polioencephalitis
RISK FACTORS:
The risk factors found to precipitate an attack of paralytic polio in individuals infected with polio include:
- Physical activity immediately following onset of paralysis
- Skeletal muscle injury due to injection of vaccines or therapeutic agents
- Pregnancy
- Vaccine associated paralytic poliomyelitis is suspected if AFP develops within45 days of receipt of OPV
- Malnutrition
- Immune deficiency
- Tonsillectomy
FEATURES:
spinal:
- Anterior horn cells is affected in spinal paralytic polio
- Absent DTRs
- No sensory deficits
- Full picture by 3 days. Usually no further progression
- Bowel and bladder dysfunction
- Older age and provocation paralysis the biphasic illness is not seen
- Recovery is slow starting after several weeks of the disease, but usually within 6 months
- If not then residual paralysis
- Recovery may continue for as long as 18 months
- Atrophy, deformity and failure to grow
Bulbar
- Nasal twang to voice and nasal regurgitation of food
- Inability to swallow and pooling of oral secretions
- Palatal and tongue involvement
- Vocal cord palsy
- Vital centers in medulla being involved
- Ascending paralysis
- Autonomic disturbances
- Recovery is variable
Paralytic poliomyelitis-Encephalitis
- Involvement of higher centers
- Seizures,coma,spastic paralysis
- Peripheral & cranial nerve palsies
- Respiratory paralysis-due to variety of possibilities
TREATMENT:
- Care of bowel & bladder
- Increased fluid intake
- Care of airway & secretions
- Monitor vital signs
- Ventilation
- Tracheostomy
- Paralytic polio is under surveillance by WHO for notification by National health Authorities
Exam Question
- IM injections and increased muscular activity increases the risk of paralytic polio
- Vaccine associated paralytic poliomyelitis is suspected if AFP develops within45 days of receipt of OPV
- In Paralytic poliomyelitis Anterior horn cell & Autonomous nervous system are affected
- Paralytic polio is under surveillance by WHO for notification by National health Authorities
- Anterior horn cells is affected in spinal paralytic polio
Don’t Forget to Solve all the previous Year Question asked on Acute paralytic polio
