What is Poliomyelitis? How can it be treated?

When we think of polio, the first thing that comes to mind is usually paralysis, but this complication can occur in both sexes. Although most patients recover slowly, some progress quickly. The extent of paralysis is related to the amount of neuronal damage. 50% of the neurons that supply the muscles die. Paralysis occurs between two and three days after the onset of the disease, and progression rarely occurs after this time. Some patients experience bowel or bladder dysfunction, including urinary retention.

Paralytic poliomyelitis

Paralytic poliomyelitis is a form of polio that can cause severe muscle weakness. Symptoms of the disease include fever, neck stiffness, muscle wasting, and weakened breathing. Paralysis affects muscles of the lower and upper body, including the legs, arms, and breathing. The condition is sometimes fatal. Symptoms can be vague and include irritability and poor control of mood and behavior.

About 10% of individuals with paralytic poliomyelitis recover completely; however, about 80% of the affected individuals will suffer some degree of permanent paralysis. Treatment of poliomyelitis can include physical therapy and use of heat to stimulate the muscles. However, if the paralysis remains after 12-18 months, it is generally irreversible. In addition, the mortality rate of paralytic poliomyelitis is higher among adults than children. Up to 5% of children die.

Since the first cases of paralytic poliomyelitis in the United States in the 1950s, a vaccine-associated poliovirus has been identified in a small number of people. In the United States, polioviruses are spread by human contact. Vaccination is recommended to prevent the disease. Paralytic poliomyelitis has been reported in humans in many parts of the world.

While polio infections may be biphasic in children, the course of the disease is usually two to three days long for both the major and minor phase. Infants usually experience a minor illness with fever and muscle pain, while adults tend to have more severe neurological symptoms. Adults suffer more severe pain and paralysis. However, the disease can cause serious health problems and may even lead to death if it is not treated.

Infected individuals may experience mild or no symptoms, while 1% or 5% develop full-blown poliomyelitis. Non-paralytic aseptic meningitis (NAPM) is characterized by stiffness and muscle weakness. While paralytic poliomyelitis is the most severe form of poliovirus infection, it is a rare and life-threatening condition that may result in permanent disabilities.

Nonparalytic poliomyelitis

There are two forms of polio: abortive poliomyelitis and nonparalytic polisomyelitis. Children who contract polio are at a high risk for developing paralysis. Symptoms of poliomyelitis include generalized muscle weakness and wasting, weakened breathing and severe constipation. A child may experience drooling, poor temper control, and flushed skin.

Adults who contracted paralytic poliomyelitis during childhood may develop noninfectious post-polio syndrome (PPS). Unlike paralytic amputations, PPS occurs fifteen to forty years later and is characterized by a gradual and irreversible deterioration of muscles, usually in muscle groups involved in the original infection. Common symptoms of PPS include muscle and joint pain. Studies are not clear on the prevalence and incidence of PPS, but estimates range from 25 to 40% of survivors.

The duration of paralysis is variable, with some patients advancing to full paralysis while others recover slowly. Paresis and progress are correlated with the severity of neuronal damage. When 50% or more of the neurons supplying muscles have been destroyed, paralysis results. In cases where paralysis is present within the first two to three days, patients usually develop bladder and bowel dysfunction. Two chimpanzees showed cord lesions, while four control chimpanzees did not exhibit such abnormalities.

In patients with post-polio syndrome, axonal sprouting from survivors of paralytic poliomyelitis may be detected later in the disease. This compensation process, however, depends on whether there are adequate amounts of surviving motoneurons. However, in cases where nonparalytic poliomyelitis is present, the initial neuronal damage may go undetected. In cases where it does, the axonal sprouts cannot support the new neuronal cells.

The onset of paralytic poliomyelitis in humans is rare, occurring in less than 0.1% of people who are infected with poliovirus. The disease manifests as three distinct clinical syndromes. Each one differs by the CNS portion of the body that is most affected: spinal, bulbar, and bulbar. Among these, bulbar poliomyelitis is the most severe.

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