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== Medical Therapy==
== 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.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
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 and prevention of [[complications]].<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>


===Supportive Care===
===Supportive Care===
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Psychological management of the disease should also be provided to the patient, in order to help him deal with the disease and accompanying disabilities.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
Psychological management of the disease should also be provided to the patient, in order to help him deal with the disease and accompanying disabilities.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
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No cure for polio exists, and the focus of modern polio treatment has been on increasing comfort, speeding recovery and preventing complications. Supportive measures include: [[antibiotics]] to prevent infections in weakened muscles, [[analgesics]] for pain, moderate exercise and a nutritious diet. Treatment of polio also often requires long-term rehabilitation including physical therapy, braces, corrective shoes and, in some cases, [[orthopedic surgery]].


Portable ventilators may be required to support breathing. Historically, a noninvasive negative-pressure ventilator (more commonly called an iron lung) was used to artificially maintain respiration during an acute polio infection until a person could breathe independently; generally about one to two weeks. Today many polio survivors with permanent respiratory paralysis use modern jacket-type negative-pressure [[ventilator]]s that are worn over the chest and abdomen.
Other historical treatments for polio have included [[hydrotherapy]], [[electrotherapy]] and surgical treatments such as tendon lengthening and nerve grafting. The use of devices such as rigid braces and body casts—which tended to cause muscle atrophy due to the limited movement of the user—were also touted as effective treatments. Massage, passive motion exercises, and vitamin C were also used to treat polio victims, with varying degrees of success.
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 17:44, 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

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 and prevention of complications.[1]

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.[2]

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:[3]

  • 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.[4]

In spinal poliomyelitis, leading to paralysis or weakness of the bladder, catheterization may be indicated.[5]

Psychological management of the disease should also be provided to the patient, in order to help him deal with the disease and accompanying disabilities.[6]

References

  1. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  3. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  4. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  5. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  6. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.

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