Polio physical examination: Difference between revisions
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:* [[Kernig's sign]] | :* [[Kernig's sign]] | ||
:* [[Brudzinski's sign]] | :* [[Brudzinski's sign]] | ||
* Initially [[hyperactive]] deep tendon [[reflexes]], that | * Initially [[hyperactive]] deep tendon [[reflexes]], that later become absent. | ||
* Common combinations of limb involvement include: | |||
:* One lower limb, followed by one upper limb | |||
:* Both lower limbs, followed by both upper limbs | |||
* Quadriplegia is a rare finding in infants. | |||
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Although occasional cases progress from the onset of weakness to complete quadriplegia and bulbar involvement in a few hours, more commonly the paralysis extends over 2 to 3 days. Progression of paralysis stops when the patient becomes afebrile.28 Paralysis of the bladder is usually associated with paralysis of the legs. It occurs in about 25% of adults but is uncommon in children. Sensory loss in poliomyelitis is very rare30 and its occurrence should strongly suggest some other diagnosis (e.g., Guillain-Barré syndrome). | |||
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Revision as of 04:16, 3 September 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Physical Examination
About 95% of patients with an healthy immune system are asymptomatic and have a normal physical examination.[1]
4 to 8% of poliovirus infection may lead abortive poliomyelitis, a mild symptomatic disease with little findings on physical exam. 2 to 3 days of fever may be the only finding.[2]
Poliovirus infection may cause non-paralytic (1-2%) or paralytic (<1%) forms of the disease. Physical findings in these forms of the disease may include:
Non-Paralytic Poliomyelitis
Meningeal signs may be present on physical exam, such as:[3]
Paralytic Poliomyelitis
Spinal Paralytic Poliomyelitis
Vitals
Temperature
- A fever is often present
Extremities
- Weakness of the extremities, predominantly of the proximal muscles, is characteristic of this form of the disease. Lower extremities are more often involved.
- Asymmetrical flaccid paralysis, predominantly of the proximal muscles, is characteristic of this form of the disease. Lower extremities are more often involved.
Neurologic
- Meningeal signs may be present on physical exam, such as:[4]
- Initially hyperactive deep tendon reflexes, that later become absent.
- Common combinations of limb involvement include:
- One lower limb, followed by one upper limb
- Both lower limbs, followed by both upper limbs
- Quadriplegia is a rare finding in infants.
Bulbar Paralytic Poliomyelitis
Polioencephalitis
References
- ↑ "Poliomyelitis".
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.