Poliomyelitis

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Symptoms	Surgery	Test	Special Topic

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Poliomyelitis

Alternative Names:

Polio; Infantile paralysis
Symptoms:

There are three basic patterns of polio infection: subclinical infections, nonparalytic, and paralytic. Approximately 95% of these are subclinical infections, which may go unnoticed.

Clinical poliomyelitis affects the central nervous system (brain and spinal cord) and is divided into nonparalytic and paralytic forms. It may occur after recovery from a subclinical infection.

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SUBCLINICAL INFECTION

no symptoms, or symptoms lasting 72 hours or less
slight fever
headache
general discomfort or uneasiness (malaise)
sore throat
red throat
vomiting

NONPARALYTIC POLIOMYELITIS

symptoms last 1 to 2 weeks
moderate fever
headache
vomiting
diarrhea
excessive tiredness, fatigue
irritability
pain or stiffness of the back, arms, legs, abdomen
muscle tenderness and spasm in any area of the body
neck pain and stiffness
pain front part of neck
back pain or backache
leg pain (calf muscles)
skin rash or lesion with pain
muscle stiffness

PARALYTIC POLIOMYELITIS

fever, occurring 5 to 7 days before other symptoms
headache
stiff neck and back
muscle weakness, asymmetrical (only on one side or worse on one side)
- rapid onset
- progresses to paralysis
- location depends on where the spinal cord is affected
abnormal sensations (but not loss of sensation) of an area
sensitivity to touch, mild touch may be painful
difficulty beginning to urinate
constipation
bloated feeling of abdomen
swallowing difficulty
muscle pain
muscle contractions or muscle spasms, particularly in the calf, neck, or back
drooling
breathing difficulty
irritability or poor temper control
positive Babinski's reflex

Signs and tests:

Examination may shows signs of meningeal irritation (similar to meningitis), such as stiff neck or back stiffness with difficulty bending the neck. When sitting, the person may need to support the body with the arms.

The person may have difficulty lifting the head or lifting the legs from a supine position (lying flat on the back). Reflexes may be abnormal. The disorder may resemble encephalitis, and it may affect the cranial nerves and cause difficulty with facial expression, swallowing, chewing, and so on. It may also cause choking or difficulty breathing.

Viral cultures of throat washings, stools, or cerebrospinal fluid (CSF) confirm the diagnosis (see CSF collection). Routine CSF examination may be normal or show slight increase in pressure, protein, and white blood cells.