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Poliomyelitis

• Acute viral infectious disease (3 types of polio virus, enterovirus)
• "Polio" = grey (spinal cord) and itis
• 90% infections cause no symptoms
• 1% infections enter the CNS: preferentially destroying motor neurons leading to muscle weakness and acute flaccid paralysis;

• different types of paralysis occurs depending on nerves involved 
• weakness in muscle proportional to number of motor units destroyed
• 60% of units have to be affected before weakness is clinically detectable
• Muscles innervated by the cervical and lumbar enlargements are most commonly affected; paralysis twice as common in the lower as the upper limb.

• Oropharyngeal > alimentary lymph nodes > enter circulation (incubation period 6-20 days)

Clinical Features

• Determined by muscle groups affected
• Muscle contractures
• Disused limb grows shorter than usual and lenght discrepancy common

Treatment

1. Non-surgical
   • careful physiotherapy in the convalescent stage
   • contractures stretched out
2. Surgical
   • In chronic stage (2 yrs after onset of disease) may be considered
   • If contemplated it should be