Poliomyelitis - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2024-10-02T21:19:05Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Weakness DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Clinical Features */

2022-02-05T13:21:02Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
			[[File:Polio sequelle.jpg\|thumb\|Post-polio syndrome in a child demonstrating genu recurvatum (knee bends backwards) of her right leg due to muscle weakness.]]
	*>90% of infections are asymptomatic		*>90% of infections are asymptomatic
	*Minor (abortive) polio:		*Minor (abortive) polio:

Mholtz: Text replacement - "-->" to "→"

2017-02-08T18:17:05Z

Text replacement - "-->" to "→"

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	*Still endemic in Pakistan, Afghanistan, and Nigeria		*Still endemic in Pakistan, Afghanistan, and Nigeria
	*Fecal-oral transmission, virus enters through GI tract then reproduces in GI lymphoid tissues		*Fecal-oral transmission, virus enters through GI tract then reproduces in GI lymphoid tissues
	*If virus reaches critical concentration, can spread to motor nuclei of spinal cord, brainstem, and reticular formation ~~-->~~ loss of infected ~~neurons-->~~ cycle of muscle denervation/~~reinnervation-->~~ loss of muscle function		*If virus reaches critical concentration, can spread to motor nuclei of spinal cord, brainstem, and reticular formation → loss of infected neurons→ cycle of muscle denervation/reinnervation→ loss of muscle function

	==Clinical Features==		==Clinical Features==

ClaireLewis: Created page with "==Background== Neurotropic enterovirus Extremely rare in developed world, targeted for global eradication by WHO Still endemic in Pakistan, Afghanistan, and Nigeria Fe..."

2016-11-13T02:49:11Z

Created page with "==Background== *Neurotropic enterovirus *Extremely rare in developed world, targeted for global eradication by WHO *Still endemic in Pakistan, Afghanistan, and Nigeria *Fe..."

Página nueva

==Background==
*Neurotropic [[enterovirus]]
*Extremely rare in developed world, targeted for global eradication by WHO
*Still endemic in Pakistan, Afghanistan, and Nigeria
*Fecal-oral transmission, virus enters through GI tract then reproduces in GI lymphoid tissues
*If virus reaches critical concentration, can spread to motor nuclei of spinal cord, brainstem, and reticular formation --> loss of infected neurons--> cycle of muscle denervation/reinnervation--> loss of muscle function

==Clinical Features==
*>90% of infections are asymptomatic
*Minor (abortive) polio:
**[[Fever]]
**[[Diarrhea]]
**[[Headache]]
**[[Sore throat]]
*Non-paralytic polio:
**[[Fever]]
**[[Headache]]
**Meningismus
**Muscle spasms without paralysis
*Paralytic (spinal) polio (~1-2% of polio infections)
**Neuro symptoms may manifest after resolution of initial febrile illness
**Maximal paralysis at around 5 days, muscle wasting after several weeks, with most patients' paralysis resolving after about 1 year
**Flaccid muscle [[weakness]]/paralysis
**Fasciculations
**Absent or decreased reflexes
**Autonomic dysfunction (e.g. sweating disturbances, [[urinary retention]], [[constipation]]
**Neuropathic pain, paresthesias, though usually no sensory deficits on exam
**Bulbar dysfunction in about 20% of spinal polio (dysphagia, dysarthria, facial weakness)
**[[Encephalitis]]: can cause reticular formation disturbances, resulting in dysrhythmias, BP lability, hypoxia, and hypercarbia
*Post-polio syndrome
**Occurs sometime after complete resolution of initial acute symptoms
**Can involve same muscle groups affected during patient's acute illness, as well as those not affected during initial viral infection
**Symptoms include muscle weakness, atrophy, fasciculations, fatigue, insomnia, joint pain, bulbar dysfunction, respiratory dysfunction

==Differential Diagnosis==

==Evaluation==
*Evaluate for other causes of symptoms
*PCR: virus can be identified in throat washings (early), CSF (early), and stool/rectal swab (highest yield)
*CSF: Pleocytosis (PMN predominance initially, then mostly lymphocytes), usually ~normal opening pressure, protein, and glucose.

==Management==
*Protect airway, support respiration if bulbar or respiratory muscle weakness
*Supportive care, symptomatic treatment

==Disposition==
*Admit

==See Also==
*[[Weakness]]
*[[Enterovirus]]
*[[Fever in traveler]]

==External Links==

==References==
<references/>

[[Category:ID]] [[Category:Neurology]]

Poliomyelitis - Revision history

Rossdonaldson1: /* Differential Diagnosis */

Rossdonaldson1: /* Clinical Features */

Mholtz: Text replacement - "-->" to "→"

ClaireLewis: Created page with "==Background== *Neurotropic enterovirus *Extremely rare in developed world, targeted for global eradication by WHO *Still endemic in Pakistan, Afghanistan, and Nigeria *Fe..."

ClaireLewis: Created page with "==Background== Neurotropic enterovirus Extremely rare in developed world, targeted for global eradication by WHO Still endemic in Pakistan, Afghanistan, and Nigeria Fe..."