Poliomyelitis Resus
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Transcript of Poliomyelitis Resus
7/23/2019 Poliomyelitis Resus
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polio= gray matter
Myelitis= infammation o the spinal cord
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Poliomyelitis, literally meaning “grayspinal cord infammation
It is a viral inection There are three types o poliovirus andmany strains o each type
It is contagious: usually spread romperson to person.
Only harmul to humans
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irus locali!ed in the anterior horn cellso the spinal cord and certain "rainsteam motor nuclei.
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#nterovirus $%&'(
Three serotypes: ), *, +
Minimal heterotypic immunity"eteen serotypes
%apidly inactivated "y heat,
ormaldehyde, chlorine,ultraviolet light
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#ntry into mouth
%eplication in pharyn-, I tract,local lymphatics
/ematologic spread to lymphatics andcentral nervous system
iral spread along nerve 0"ers
1estruction o motor neurons
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The ant. /orn motor cells may "edamaged "y viral multiplication or to-ic
"yproducts o the virus or indirectly "yischemia, edema, and hemorrhage inthe glial tissues.
1estruction o the spinal cord occurs
ocally and ithin + days alleriandegeneration is evident.
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Most a2ects children under the age o 3years in developing tropical countries.
Incu"ation period ranges rom 4 to *5days
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'cute stage: generally lasts 6 to )5 days.
Many include ever, pharyngitis,headache, anore-ia, nausea, andvomiting. Illness may progress toaseptic meningitis andmenigoencephalitis in )7 to 87 o
patients. These patients develop ahigher ever 9 sever headache ithsti2ness o the nec and "ac.
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Paralytic disease occurs 5.)7 to )7 othose ho "ecome inected ith the
polio virus.
Paralysis o the respiratory muscles or
rom cardiac arrest i the neurons inthe medulla o"longata aredestroyed.
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;ymptoms range :rom mild malaise togenerali!ed encephalomyelitis ithidespread paralysis.
/yperesthesia or paresthesia in thee-tremities and muscular pain is
common.Muscles are tender even to gentle
palpation.
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'ccording to ;harrard, eaness isclinically detecta"le only hen more
than 457 o the nerve cells supplyingthe muscle have "een destroyed.
Paralysis occurs tice as oten in theloer e-tremity as in upper e-tremity.
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The most commonly a2ected musclesare the
<uadriceps, glutei, ti"ialis anterior,medial hamstrings, and hip fe-ors.
1eltoid, triceps, and pectoralis maor.
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Patients have some or ull recoveryrom paralysis, most clinical
recovery occurs during the ) monthand almost complete ithin 4months.
>imited recovery may occur or a"out* years.
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In cases ith paralysis super0cialrefe-es usually are a"sent 0rst, and
deep tendon refe-es disappear henthe muscle group is paraly!ed.
11?.: uillain@Aarre syndrome, and otherorms o encephalomyelitis
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Aed rest, analgesics, hot pacs, andanatomical positioning o the lim"s
gentle passive %OM e-ercises o all oints
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close monitoring o respiratory andcardiovascular unctioning is essentialduring the acute stage o poliomyelitis
along ith ever control and painrelievers or muscle spasms.
Mechanical ventilation, respiratory therapy
may "e needed depending o theseverity o patients.
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Brom * days ater the temperature returnto normal and continues or * years
Muscle poer improves
Physical therapy is recommended or ullrecovery.
Passive stretching e-ercises and edging
casts can "e used or mild to moderatecontractures.
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*8 months ater the active illness:
The goals o treatment include correctingany signi0cant muscle im"alance andpreventing or correcting sot tissue or"ony deormities.
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;tatic oint insta"ility can "e controlled"y Orthoses.
1ynamic oint insta"ility result in a 0-eddeormity that cannot "e controlled "yOrthoses.
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;ot tissue surgery, such as tendontransers, should "e done in youngchildren "eore the development o any0-ed "ony changes.
Aony procedures or correcting adeormity can "e delayed until seletal
groth is near completion.
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Prevention
Prevention
Prevention
Immuni!ation o the youngcontinues
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Live, Attenuated
3doses : 95% Efcaciuous
InjectedOral
Humoral OnlyHumoral, cell mediated
$
Dose : 9%, ! doses : 99%
"illed
$$$$
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ery important point
&o any ne case in last )5 years
reported.