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Acute Flaccid paralysis in adults: Our experience.

Kaushik R, Kharbanda PS, Bhalla A, Rajan R, Prabhakar S - J Emerg Trauma Shock (2014)

Bottom Line: Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions.We did not encounter any case of acute polio mylitis in adults.In-hospital mortality due to respiratory paralysis was 9%.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.

ABSTRACT

Unlabelled: Acute flaccid paralysis (AFP) is a complex clinical syndrome with a broad array of potential etiologies that vary with age. We present our experience of acute onset lower motor neuron paralysis.

Materials and methods: One hundred and thirty-three consecutive adult patients presenting with weakness of duration less than four weeks over 12 months period were enrolled. Detailed history, clinical examination, and relevant investigations according to a pre-defined diagnostic algorithm were carried out. The patients were followed through their hospital stay till discharge or death.

Results: The mean age was 33.27 (range 13-89) years with male preponderance (67.7%). The most common etiology was neuroparalytic snake envenomation (51.9%), followed by Guillain Barre syndrome (33.1%), constituting 85% of all patients. Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions. We did not encounter any case of acute polio mylitis in adults. In-hospital mortality due to respiratory paralysis was 9%.

Conclusion: Neuroparalytic snakebite and Guillain Barre syndrome were the most common causes of acute flaccid paralysis in adults in our study.

No MeSH data available.


Related in: MedlinePlus

Algorithm for diagnosis of acute flaccid paralysis
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Figure 1: Algorithm for diagnosis of acute flaccid paralysis

Mentions: We conducted a prospective, observational study to determine the underlying diagnosis and in-hospital course of patients presenting with acute flaccid paralysis to the emergency department of PGIMER, a tertiary care hospital in North-West India. One hundred and thirty-three consecutive patients of age above 12 years presenting with weakness of duration less than four weeks, between the period of 13 April 2010 and 12 April 2011, were enrolled in the study after informed consent. Patients with longer duration of illness, trauma, UMN involvement or hemiparesis on clinical examination were excluded. Detailed history and clinical examination were performed by a single examiner, and relevant investigations according to a pre-defined diagnostic algorithm were carried out [Figure 1]. The patients were followed through their hospital stay till discharge or death.


Acute Flaccid paralysis in adults: Our experience.

Kaushik R, Kharbanda PS, Bhalla A, Rajan R, Prabhakar S - J Emerg Trauma Shock (2014)

Algorithm for diagnosis of acute flaccid paralysis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126112&req=5

Figure 1: Algorithm for diagnosis of acute flaccid paralysis
Mentions: We conducted a prospective, observational study to determine the underlying diagnosis and in-hospital course of patients presenting with acute flaccid paralysis to the emergency department of PGIMER, a tertiary care hospital in North-West India. One hundred and thirty-three consecutive patients of age above 12 years presenting with weakness of duration less than four weeks, between the period of 13 April 2010 and 12 April 2011, were enrolled in the study after informed consent. Patients with longer duration of illness, trauma, UMN involvement or hemiparesis on clinical examination were excluded. Detailed history and clinical examination were performed by a single examiner, and relevant investigations according to a pre-defined diagnostic algorithm were carried out [Figure 1]. The patients were followed through their hospital stay till discharge or death.

Bottom Line: Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions.We did not encounter any case of acute polio mylitis in adults.In-hospital mortality due to respiratory paralysis was 9%.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.

ABSTRACT

Unlabelled: Acute flaccid paralysis (AFP) is a complex clinical syndrome with a broad array of potential etiologies that vary with age. We present our experience of acute onset lower motor neuron paralysis.

Materials and methods: One hundred and thirty-three consecutive adult patients presenting with weakness of duration less than four weeks over 12 months period were enrolled. Detailed history, clinical examination, and relevant investigations according to a pre-defined diagnostic algorithm were carried out. The patients were followed through their hospital stay till discharge or death.

Results: The mean age was 33.27 (range 13-89) years with male preponderance (67.7%). The most common etiology was neuroparalytic snake envenomation (51.9%), followed by Guillain Barre syndrome (33.1%), constituting 85% of all patients. Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions. We did not encounter any case of acute polio mylitis in adults. In-hospital mortality due to respiratory paralysis was 9%.

Conclusion: Neuroparalytic snakebite and Guillain Barre syndrome were the most common causes of acute flaccid paralysis in adults in our study.

No MeSH data available.


Related in: MedlinePlus