Polio medical therapy

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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]

Medical Therapy

There is no antiviral drug, or other kind of treatment for neither form poliomyelitis. Current management of these patients is based on supportive care towards symptom relief.

Supportive Care

Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.

Mechanical ventilation is indicated when paralysis of the respiratory muscles occurs, before development of hypoxia. It is often started once vital capacity is below 50%. Two respiratory machines are available for this purpose:

• Tank Respirators - although not commonly used, some institutions use these respirators, that were used in the past to treat the same type of patients, in order to avoid tracheal intubation and the complications that may occur from it.
• Positive-pressure Ventilators - Although requiring tracheal intubation, these machines are replacing tank respirators, allowing better access to the patient.

For patients with bulbar poliomyelitis, that is not accompanied by respiratory muscle paralysis, drainage of secretions may be accomplished by suction and postural drainage. For severe cases of bulbar paralysis, tracheal intubation may be required.

In spinal poliomyelitis, leading to paralysis or weakness of the bladder, catheterization may be indicated.

Psychological management of the disease should also be provided to the patient, in order to help him deal with the disease and accompanying disabilities.