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AAEM case report #23: acute paralytic poliomyelitis.
1Department of Neurology, School of Medicine, University of California, San Francisco.
Muscle & Nerve
|December 1, 1991
Summary
This case study details acute paralytic poliomyelitis in a 56-year-old man, highlighting rapid, asymmetric weakness and electrodiagnostic findings of denervation and reinnervation.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Electrophysiology
Background:
- Poliomyelitis remains a concern, particularly in unvaccinated populations or returning travelers.
- Enteroviruses, including poliovirus, can cause acute flaccid paralysis.
- Early diagnosis and electrodiagnostic assessment are crucial for managing paralytic illnesses.
Observation:
- A 56-year-old man presented with acute paralytic poliomyelitis following an overseas trip.
- Initial symptoms included fever and diarrhea, with an enterovirus (non-poliovirus) isolated from stool.
- Rapid, asymmetric lower extremity weakness was the primary neurological manifestation.
Findings:
- Nerve conduction studies showed reduced motor amplitudes after one week, with normal sensory findings.
- Electromyography revealed acute denervation followed by reinnervation across multiple nerve segments.
- The clinical presentation and electrodiagnostic results were consistent with acute poliomyelitis.
Implications:
- This case underscores the importance of considering poliomyelitis in the differential diagnosis of acute flaccid paralysis, even in adults.
- Electrodiagnostic studies are vital for characterizing the extent and pattern of nerve injury.
- Understanding the clinical and electrophysiological features aids in prognosis and management of paralytic poliomyelitis.