Poliomyelitis Resus

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7/23/2019 Poliomyelitis Resus

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polio= gray matter

Myelitis= infammation o the spinal cord

Poliomyelitis, literally meaning “grayspinal cord infammation

It is a viral inection There are three types o poliovirus andmany strains o each type

It is contagious: usually spread romperson to person.

Only harmul to humans

irus locali!ed in the anterior horn cellso the spinal cord and certain "rainsteam motor nuclei.

#nterovirus $%&'(

Three serotypes: ), *, +

Minimal heterotypic immunity"eteen serotypes

%apidly inactivated "y heat,

ormaldehyde, chlorine,ultraviolet light

#ntry into mouth

%eplication in pharyn-, I tract,local lymphatics

/ematologic spread to lymphatics andcentral nervous system

iral spread along nerve 0"ers

1estruction o motor neurons

The ant. /orn motor cells may "edamaged "y viral multiplication or to-ic

"yproducts o the virus or indirectly "yischemia, edema, and hemorrhage inthe glial tissues.

1estruction o the spinal cord occurs

ocally and ithin + days alleriandegeneration is evident.

Most a2ects children under the age o 3years in developing tropical countries.

Incu"ation period ranges rom 4 to *5days

'cute stage: generally lasts 6 to )5 days.

Many include ever, pharyngitis,headache, anore-ia, nausea, andvomiting. Illness may progress toaseptic meningitis andmenigoencephalitis in )7 to 87 o

patients. These patients develop ahigher ever 9 sever headache ithsti2ness o the nec and "ac.

Paralytic disease occurs 5.)7 to )7 othose ho "ecome inected ith the

polio virus.

Paralysis o the respiratory muscles or

rom cardiac arrest i the neurons inthe medulla o"longata aredestroyed.

;ymptoms range :rom mild malaise togenerali!ed encephalomyelitis ithidespread paralysis.

/yperesthesia or paresthesia in thee-tremities and muscular pain is

common.Muscles are tender even to gentle

palpation.

'ccording to ;harrard, eaness isclinically detecta"le only hen more

than 457 o the nerve cells supplyingthe muscle have "een destroyed.

Paralysis occurs tice as oten in theloer e-tremity as in upper e-tremity.

The most commonly a2ected musclesare the

<uadriceps, glutei, ti"ialis anterior,medial hamstrings, and hip fe-ors.

1eltoid, triceps, and pectoralis maor.

Patients have some or ull recoveryrom paralysis, most clinical

recovery occurs during the ) monthand almost complete ithin 4months.

>imited recovery may occur or a"out* years.

In cases ith paralysis super0cialrefe-es usually are a"sent 0rst, and

deep tendon refe-es disappear henthe muscle group is paraly!ed.

11?.: uillain@Aarre syndrome, and otherorms o encephalomyelitis

Aed rest, analgesics, hot pacs, andanatomical positioning o the lim"s

gentle passive %OM e-ercises o all oints

close monitoring o respiratory andcardiovascular unctioning is essentialduring the acute stage o poliomyelitis

along ith ever control and painrelievers or muscle spasms.

Mechanical ventilation, respiratory therapy

may "e needed depending o theseverity o patients.

Brom * days ater the temperature returnto normal and continues or * years

Muscle poer improves

Physical therapy is recommended or ullrecovery.

Passive stretching e-ercises and edging

casts can "e used or mild to moderatecontractures.

*8 months ater the active illness:

The goals o treatment include correctingany signi0cant muscle im"alance andpreventing or correcting sot tissue or"ony deormities.

;tatic oint insta"ility can "e controlled"y Orthoses.

1ynamic oint insta"ility result in a 0-eddeormity that cannot "e controlled "yOrthoses.

;ot tissue surgery, such as tendontransers, should "e done in youngchildren "eore the development o any0-ed "ony changes.

Aony procedures or correcting adeormity can "e delayed until seletal

groth is near completion.

Prevention

Immuni!ation o the youngcontinues

Live, Attenuated

3doses : 95% Efcaciuous

InjectedOral

Humoral OnlyHumoral, cell mediated

Dose : 9%, ! doses : 99%

"illed

ery important point

&o any ne case in last )5 years

reported.

Poliomyelitis Resus

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