Transcript Bulbar polio

polio
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Poliomyelitis, often called polio or infantile
paralysis, is an acute viral infectious disease
which is spread from person-to-person via the
fecal-oral route.
The majority of polio infections are asymptomatic.
In about 1% of cases the virus enters the central
nervous system (CNS) via the blood stream.
Within the CNS, poliovirus preferentially infects
and destroys motor neurons.
The destruction of motor neurons causes muscle
weakness and flaccid paralysis.
Paralytic polio
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In approximately 1 in 100 to 1 in 1000 cases poliovirus
infection leads to paralytic disease, in which patients
develop flaccid paralysis.
Depending on the site of paralysis, poliomyelitis can be
classified as spinal, bulbar, or spino-bulbar.
Up to 0.2% of all polio infections (but nearly 20% of
paralytic polio cases) require mechanical ventilation of
the patient during the acute stage, and permanent
quadriplegia or respiratory paralysis occur in only 0.01%
(1 in 10,000) of all poliovirus infections.
Spinal polio
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The location of motor neurons in the anterior horn cells of the
spinal column.
The poliovirus affects the motor neurons of the anterior horn
cells, or the ventral (front) grey matter section in the spinal
column, which control movement of the trunk and limb
muscles including the intercostal muscles.[23] The color and
appearance of the grey matter of the spinal cord are often
altered by polio infection, appearing reddish and swollen due
to extensive inflammation, caused by replication of polio virus
within the motor neurons of the anterior horn and brain stem.
This inflammation results in damage or destruction of motor
neuron ganglion within the grey matter; causing the typical
clinical symptoms of poliomyelitis.[23]
Bulbar polio
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The location and anatomy of the bulbar
region (in orange).
Bulbar polio and spinal polio are part of a
continuum of anatomy and disease
(paralytic polio). Bulbar polio occurs in 2%
of cases of paralytic polio, and describes
the form of the disease which affects the
bulbar region of the brain stem.
Diagnosis
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Polio is a rare disease in much of the world, and
few doctors have ever seen a case of polio. If
polio is suspected, however, the usual follow-up
test is a lumbar puncture, or "spinal tap", to collect
the patient's cerebrospinal fluid (CSF). The CSF
of individuals with polio contains an increased
number of white blood cells (primarily
lymphocytes) and a mildly elevated protein
level.[27]
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When poliovirus is isolated from a patient
experiencing acute flaccid paralysis, it is then
further tested, using oligonucleotide mapping
(genetic fingerprinting), or more recently by by
PCR amplification, to determine if the virus is “wild
type” (that is, the virus encountered in nature) or
vaccine type (is derived from a strain of poliovirus
used to produce polio vaccine).
Isolation of wild poliovirus constitutes a public
health emergency, and appropriate control efforts
must be initiated immediately.
Treatment
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The iron lung
Antibody serum
Vaccine
Salk's "inactivated polio vaccine"
Sabin's "oral polio vaccine"