ACUTE POLIOMYELITIS

POLIOMYELITIS

Ques. 1     What is Acute Poliomyelitis?

Ans.          It is an acute disease characterized by lesions having a special affinity of the grey matter of the anterior horns of the spinal cord and for the motor nuclei of the brain stem.

Causes: Infection is carried mainly by food or fomites; through droplets of the healthy carriers.

Caused by a virus of which there are 3 types; Brunhlde, Lansing & Leon. They reach central nervous system by blood or through axis cylinder of peripheral of autonomic nerves. Incubation period is usually 7-30 days.

Predisposing factors : Age – mostly 4 to 10 years. Sex-mostly males.

Clinical Features (Signs and Symptoms):

Minor illness : (i) Malaise. (ii) Lassitude, weakness. (iii) Anorexia. (iv) Vomiting. (v) Sore throat etc. (vi) Fever. (vii) Headache.

Major illness : (1) Pre-Paralytic stage –

  1. anorexia, nausea and vomiting,
  2. restlessness and delirium,
  3. pains in the neck, back and limbs,
  4. diarrhoea,
  5. convulsions,
  6. about 103F,
    • sometimes diplopia,
  7. neck rigidity,
  8. small involuntary movements in the fingers and hands.
  9. occipital headache,
  10. malaise, weakness,

Paralytic stage: Spinal type (most common)-

  • sensory normal,
  • muscles tender on pressure,
  • Spasm in the back of the neck, the erector and hamstring muscles,
  • maculopapular eruptions on the affected limb,
  • flaccid paralysis of muscles (mostly legs),
  • deep reflexes generally sluggish or lost,
  • abdominal reflexes abolished,

Brain-stem type –

  1. bulbar lesions-dysphagia, dysarthria, dysphonia, dyspnoea and cardiac irregularities.
  2. VII, VI and III cranial nerves commonly affected,

Neuritic type-

  • deep reflexes diminished.
  • severe pains in the arms or legs,

Cerebellar type –

  1. dysarthria,
  2. ataxia of spinal muscles,
  3. vertigo, headache,
  4. vomiting on moving the head,

Cerebral type –

  • extensor planster response,
  • mental deterioration,
  • athetoic or choreic movements.
  • generalized convulsions,
  • apastic paraplegia or hemiplegia,

Complications :

  1. Progressive muscular atrophy.
  2. Contractures and deformities, e.g. scoliosis, kyphosis, lordosis.

Differential Diagnosis :

  • Rheumatic fever.
  • Infantile scurvy and osteomyelitis.

Treatment:

  1. In bulbar type- Foot end of the bed is raised, secretions are aspirated, artificial respirators should be used.
  2. If excessive sweating, plenty of fluids by mouth. (5) Prophylaxis – oral vaccination.
  3. Bed rest, the foot end of the bed is raised by about 18” –
  4. Gentle passive movement of the paralysed muscles may be done.

Ques. 2     Which Homoeopathic Remedies are useful?

Ans.          Homoeopathic remedies

  • CAUSTICUM – Trembling of the extremities when walking or standing but not when sitting, paralysis implicating breating, numbness & insensibility of the back arresting the breathing & insensibility of the fingers and toes, with a feeling of icy coldness & tending to cramp.
  • ABROTANUM – Rheumatic myelities, suddenly appearing, sudden aching pains, better by motion; numbness and paralysis, disposed to lie prone from soreness all over.
  • GELSEMIUM – Early stage of myelitis esp. when involving the anterolateral columns of the cord, cerebrospinal symptoms; confusion of head, extending from occiput to forehead, paralysis of tongue and glottis, spinal exhaustion, incontinence of urine, loss of voluntary motion.
  • Pains in the back, with weakness and weariness; tonic and clonic spasms, partial or general paralysis, dyspnoea, paralysis of the ocular muscles and iris.

Ques. 3     Which Biochemic Remedies are useful?

Ans.          Biochemic remedies :-

  • NATRUM PHOS. Weakness of lower limbs from the knees down. Legs give under her when she walks.
  • SILICA – Paralysis from tabes dorsalis. Paralytic weakness of the joints. Obstinate neuralgia, occurring at night, when neither heat nor cold gives relief.
  • MAG PHOS. – Paralysis of the white nerve fibres. Palsy, involuntary shaking & trembling of the hands or of the head. ‘Muscular paralysis caused by a disturbed or diseased condition of the efferent nerve fibres which convey the motor stimulus to the muscles’.
  • KALI PHOS. – This is the first remedy to be considered in all cases of paralysis, whether creeping or sudden in its onset. Paralysis of vocal cords, causing loss of voice. Locomotor paralysis, creeping paralysis, with atrophic conditions, vital powers are reduced & stools have a putrid odor. Facial paralysis, partial paralysis, hemiplegia, facial or infantile paralysis.
  • CALC PHOS – Patient is tired and weary. Pains very severe at night, with sensation of creeping numbness & coldness. Pains shoot all over the body like electrical shocks, and at other times like tricking of cold water. Neuralgia (nerve pains) which are worse at night, colic cramps, spasms, convulsions, etc. Paralysis, when associated with the rheumatism.
  • NATRUM MUR. – Paralysis of flexors; paralytic condition of lower limbs; painful contraction of hamstrings; hysterical debility; great weakness and relaxation of all physical and mental vigor from exertion.

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