POLIOMYELITIS

Poliomyelitis is a viral infection affecting the anterior horn

cells in the spinal cord and brainstem producing a flaccid
motor paralysis.
ETIOLOGY
The causative organism of poliomyelitis is an enterovirus,
which is specific in its action, and primarily attacks and
destroys the anterior horn cells. The predominant age
group atfected is children between the ages of 1-4 years,
but theoretically no age is immune. The disease is highly
infectious. The virus spreads rapidly in a community by
carriers' as well as by those who are in the incubation
perniod or early stages of the disease, by droplet intection
or more commonly feco-oral route [the gastrointestinal
tract; the incubation period is +14 days.
The disease process may be staged as,
Stagel Acute stage (of Paralysis)
Stage II Recovery
Stage 3- Residual paralysis.
Clinical Manifestation
Depending on the host immunity, the vius may produce no
infection, sub cinical intection, and symptoms with or
without paralysiS. Ihe paralysis itself may be transient,
mild or severe. Sometimes there are no symptoms even if
the virus iS present in the body.
Paralytic Poliomyelitis
Involvement of motor nerve cells in the spinal cord,
resulting in paresis or paralysis of various muscles.
Paralytic poliomyelitis may be subdivided into
the following types:
Spina
Bulbar
Bulbospinal
Polio encephalitis.
Spinal Paralytic Poliomyelitis
In the early stages of spinal paralytic poliomyelitis there is
severe cramping pain in the muscles with hyperaesthesia
of the overlying skin. In children less than years old,
paresis or one leg 1s mOst common. In patients between
5 and 15 years of age weakness of one arm or both lower
extremities is more frequent. Paralysis of the muscles of
respiration is often present in those over 16 years ot age
getting infected.
Bulbar Poliomyelitis
Damage to the medulla, pons, and midbrain with
dystunction ot the cranial
nerve nuclei and the respiratory and vasomotor regulating
centres
Bulbospinal Poliomyelitis
Also known as respiratory poliomyelitis this form has
symptoms both of spinal and bulbar manifestations. It
affects the upper part of the spinal cord C3 to C5
segments and causes paralysis of the diaphragm.
cOMMON DEFORMITIES IN POLIO
In Lower limb
Hip-flexion, adduction and internal rotation.
Knee-flexion or hyperextension.
Ankle and foot-plantar flexion inversion and forefoot
adduction, valgus
and collapsed arches.
In Upper limb
Shoulder-flexion, adduction and internal rotation.
Elbow-flexion, pronation
Wrist and fingers -flexion.