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Poliomyelitis In EGYPT 2013 !!
1. Poliomyelitis Electrodiagnosis
Dr Mohamed ibrahim khalil
physical medicine Rheumatology and rehabilitation ,
Alexandria University EGYPT
To contact Dr M. Ibrahim
Reverie-forever@hotmail.com
2. History
A 1.5 year-old child named Abdel-Rahman Ali
Basiouny presented with weakness of left upper
and lower limb and inability to walk of 2 days
duration
3. โข The condition started 20 days ago with
acute onset of high fever (39 C ) and
common cold which Resolved on medical
tratment
โข A week later the high fever recurred and
associated with Acute severe weakness of
left upper and lower limbs and inability to
walk
4. After three days the fever resolved on
medical treatment while the weakness
Persists ( The weakness was maximum
from the start )
** MRI Brain was done which revealed normal
findings .
The patient then refered to do electrophysiological
study .
5. โข
โข
โข
โข
โข
No history of similar attacks
No history of head trauma
No history of change of consciousness
No history of convulsions
NO history of involuntary movements
6. โข Past Medical History : Irrelvant
โข Family History : Irrelevant
โข Vital signs :
Pulse 95 b/min
Respiration 16 /min
Blood Pressure 125/90
Temperature 37 C
7. Physical examination
1- Mental or intellectual function:
โข The Patient is fully conscious, alert
oriented
2- Speech and articulation : Normal
3- Cranial nerves : Free
8. 4- Sensory examination : intact
5- Gait : inability to walk
6- Motor examination :
โข Muscle state : Normal
โข Muscle Tone :HYPOTONIA on Left upper
and lower Limbs
โข No involuntary movements
โข No fasiculations
32. Where is Polio present
TODAY
โข In 2008, only four countries in the world remain with
polio-endemic, down from more than 125 in 1988.
The remaining countries are Afghanistan, India,
Nigeria and Pakistan.
12/15/13
Dr.T.V.Rao MD
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43. Polio โ like syndromes
โข patients with suspected poliomyelitis, but
from whom poliovirus was not isolated, a
variety of causes of the paralysis was
found.
44. โข Enterovirus infections, especially
coxsackieviruses A9 and A23 (echovirus 9) and
group B coxsackieviruses, frequently caused
meningoencephalitis often associated with
transient paralysis. Coxsackievirus A7 infection
occasionally resulted in permanent paralysis.
โข Exotic causes included paralysis due to snake
bite, spider bite, scorpion sting, and tick bite and
schistosomiasis involving the spinal cord
45. โข Chemical poisons, such as arsenic,
triorthocresyl phosphate, and
organophosphorus insecticides,
โข Paralysis in individual patients with
porphyria followed the administration of
anesthesia and certain drugs.
46. โข The Guillain-Barrรฉ syndrome in some
patients resulted from virus infection of the
nerve tissue, in others it was related to a
hyperreactive autoallergic state.
โข Injury of the spinal column sometimes
followed by periostitis or osteomyelitis was
relatively common.