Polio

Polio (also called poliomyelitis) is a contagious, historically devastating ailment that was virtually eliminated in the Western hemisphere in the other half of the 20th century. Polio is really a contagious viral illness that in the most severe form causes paralysis, breathlessness and sometimes death. The Centers for Disease Control and Prevention (CDC) advises taking precautions to safeguard against polio if you're traveling anywhere there is a risk of polio. If you're a previously vaccinated adult who plans to travel for an area where polio is happening, you should receive a booster dose of inactivated poliovirus (IPV). Immunity carrying out a booster dose lasts an eternity.

Types of polio

Spinal Paralytic poliomyelitis: Within this the motor neurons within the anterior horns of spinal cord may take a hit. Paralysis is usually asymmetrical, predominantly involves proximal muscle with pain and tenderness. Most often it affects the lower limb. Extent of weakness can differ from a single muscle group to accomplish tetraparesis.

Bulbar Paralytic poliomyelitis: It occurs due to harm to the medulla, pons and midbrain with dysfunction from the cranial nerve nuclei and respiratory and vasomotor regulating centres within the medulla. It can lead to respiratory muscle failure, distress of respiratory control, dysphagia, dysphonia and dysarthria. Cardiovascular, sweating and gut mobility disturbances may occur.

Bulbospinal paralytic poliomyelitis: It's also known as respiratory poliomyelitis. It's symptoms both of spinal-cord and bulbar poliomyelitis. It affects negligence spinal cord C3 to C5 segments and results in paralysis of the diaphragm. Dysphagia and respiratory failure follow.

Polio encephalitis: There's inflammation of motor neurons inside the brain stem, motor cortex and also the spinal cord. It results in the stiffness of neck and back, muscle cramps, headaches and paraesthesias. Paralysis occurs within Ten days after symptoms develop progress in 2 to 3 days and finish by the time fever subsides.

Polio Symptoms

Although polio may cause paralysis and death, most people who are infected with the poliovirus don't become sick and therefore are never aware they have been infected with polio.

Nonparalytic polio 

Some people who develop symptoms in the poliovirus contract nonparalytic polio - a kind of polio that doesn't lead to paralysis (abortive polio). This usually causes exactly the same mild, flu-like signs and symptoms usual for other viral illnesses.

Signs or symptoms, which generally  10 days, include:

• Fever

• Sore throat

• Headache

• Vomiting

• Fatigue

• Back pain or stiffness

• Neck pain or stiffness

• Pain or stiffness within the arms or legs

• Muscle spasms or tenderness

• Meningitis

Paralytic polio 

In rare cases, poliovirus infection results in paralytic polio, the most serious type of the disease. Paralytic polio has several types, in line with the part of your body that's affected - your spinal-cord (spinal polio), your brainstem (bulbar polio) or both (bulbospinal polio).

Initial indications of paralytic polio, such as fever and headache, often mimic the ones from nonparalytic polio. Within a week, however, signs or symptoms specific to paralytic polio appear, including:

• Loss of reflexes

• Severe muscle aches or spasms

• Loose and floppy limbs (flaccid paralysis), often worse somewhere of the body

The start of paralysis may be sudden.

Post-polio syndrome 

Post-polio syndrome is really a cluster of disabling signs or symptoms that affect some people for decades - typically 25 to 35 years - once they had polio. Common signs or symptoms include:

• Progressive muscle or joint weakness and pain

• General fatigue and exhaustion after minimal activity

• Muscle atrophy

• Breathing or swallowing problems

• Sleep-related breathing disorders, for example sleep apnea

• Decreased tolerance of cold conditions

Examination of the patient

An extensive and detailed assessment is essential at the first consultation to determine a baseline from which future changes could be evaluated and a polio treatment plan developed. An exam will usually have three components; neurological musculoskeletal cardiorespiratory

• neurological

• musculoskeletal

• cardiorespiratory

Neurological Examination in polio treatment include-

• New weakness in previously affected or unaffected muscles

• Decreased muscular endurance

• Gait changes

• History of falls

• Decreased function

• Other lower motor neuron signs - decreased tone, reflexes and muscle atrophy

Musculoskeletal Examination in polio treatment include-

• Range of movement testing especially for the joints affected

• Muscle testing, especially of muscles which are weak. Also test muscles that should be strong to make up for the weak ones (shoulder strength for crutch use)

• Check for deformities, contractures, dislocations, difference in leg length, spinal curve etc

Cardiorespiratory Examination in polio treatment include-

• Reduced pulmonary function is a result of the virus affecting the medullary respiratory centres, the muscles of respiration and also the cranial nerves.

• Thoracic cage deformity, e.g. kyphoscoliosis

• Breathing problems

• Measurement of peak flow, oxygen saturation, and interpretation of theresults of pulmonary function tests

• Forced expiratory techniques for example coughing and huffing to evaluate apatient’s ability to expectorate secretions effectively ought to be assessed

Each child may have a different combination and harshness of paralyzed muscles and can have his own special needs. For some children, normal exercises and play might be all that are needed. Others may need braces or other aids to help them maneuver around better. Those who are severely paralyzed may need wheelchair.