Definition of Paralysis, infantile (polio)
Paralysis, infantile (polio): Infantile paralysis is
an old synonym for poliomyelitis, an acute and sometimes devastating
viral disease. Man is the only natural host for poliovirus. The virus
enters the mouth and multiplies in lymphoid tissues in the pharynx
and
intestine. Small numbers of virus enter the blood and go to other
sites where the virus multiplies more extensively. Another
round of viremia (virus in the bloodstream) leads to invasion of the
central nervous system (CNS), the spinal cord and brain, the only
sites seriously struck by the virus.
In polio, there is inflammation of the central nervous system,
especially the anterior horn cells of the spinal cord and the
brainstem (the portion of the brain between the cerebral
hemispheres and spinal cord).
Polio can be a minor illness, as it is in 80-90% of clinical
infections, chiefly in young children, and not involve the CNS.
Symptoms are slight fever, malaise, headache, sore throat, and
vomiting 3-5 days after exposure. Recovery occurs in 24-72 hours.
This is termed the abortive type of polio.
Polio as a major illness may or may not be paralytic.
Symptoms usually appear without prior illness, particularly in older
children and adults, 7-14 days after exposure. Symptoms are fever,
severe headache, stiff neck and back, deep muscle pain, and sometimes
areas of hyperesthesia (increased sensation) and paresthesia (altered
sensation). There may be no further progression from this picture of
viral meningitis or there be loss of tendon reflexes
and weakness or paralysis of muscle groups.
Recovery is complete in the abortive and nonparalytic forms of
polio. In paralytic polio, about 50% of patients recover with no
residual paralysis, about 25% are left with mild disabilities, and
the remaining patients have severe permanent disability. The greatest
return of muscle function occurs in the first 6 months, but
improvement may continue for up to 2 years. Physical therapy is the
most important part of treatment of paralytic polio during
convalescence. The ideal strategy with polio is clearly to prevent it
by immunization against poliovirus.
U.S. President Franklin D. Roosevelt (1882-1945) had polio and
worked with the National Foundation/March of Dimes to raise money to
combat this once-fearsome scourge.
Last Editorial Review: 2/11/1999 7:23:00 PM
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