Acute flaccid paralysis: Difference between revisions
From IDWiki
(Imported from text file) |
No edit summary |
||
| Line 1: | Line 1: | ||
== |
==Differential Diagnosis== |
||
{| class="wikitable" |
|||
! |
|||
![[Guillain-Barré syndrome]] |
|||
![[Poliovirus|Paralytic poliomyelitis]] |
|||
|- |
|||
|Fever |
|||
|afebrile |
|||
|febrile with myalgias |
|||
|- |
|||
|Progression |
|||
|subacute, days to weeks |
|||
|acute, peaks at 2-4 days |
|||
|- |
|||
|Neurological deficits |
|||
|ascending, symmetric muscle weakness with decreased DTRs |
|||
|asymmetric weakness with increased DTRs; proximal more than distal, and legs more than arms |
|||
|- |
|||
|Sensory changes |
|||
|mild disturbances or paresthesias |
|||
|none |
|||
|- |
|||
|CSF findings |
|||
|minimal or no pleocytosis, but elevated protein ([[albuminocytologic dissociation]]) |
|||
|pleocytosis with elevated protein, normal glucose ([[aseptic meningitis]]) |
|||
|} |
|||
* |
*Infection |
||
** |
**Viral |
||
***[[Picornaviridae]] |
|||
*** Other enteroviruses |
|||
**** |
****'''[[Enterovirus|Enterovirus 71]]''' |
||
**** |
****'''[[Enterovirus|Enterovirus D68]]''' |
||
**** |
****[[Enterovirus|Coxsackievirus A7]] |
||
****[[Poliovirus]] |
|||
*** Flaviviridae: '''West Nile virus''', Japanese encephalitis |
|||
***[[Flaviviridae]]: '''[[West Nile virus]]''', [[Japanese encephalitis virus|Japanese encephalitis]], [[Tick-borne encephalitis virus|Tick-borne encephalitis]] |
|||
*** |
***[[Herpesviridae]]: [[CMV]], [[EBV]], [[VZV]] |
||
*** Tick-borne encephalitis |
|||
*** |
***[[HIV]]-related opportunistic infections |
||
*** Rabies |
***[[Rabies virus|Rabies]] |
||
** |
**Bacteria |
||
*** |
***[[Borrelia burgdorferi]] |
||
***[[Corynebacterium diphtheriae]] |
|||
*** Diphtheria |
|||
***[[Clostridium botulinum]] |
|||
*** Botulism |
|||
*** |
***[[Mycoplasma pneumoniae]] |
||
* |
*Neuropathy |
||
** |
**'''[[Guillain-Barré syndrome]]''', though it is typically symmetrical and bilateral ascending paralysis that may include loss of sensation |
||
** |
**[[Acute motor axonal neuropathy]] |
||
** |
**[[Critical illness neuropathy]] |
||
** |
**[[Lead poisoning]] |
||
** |
**Other [[heavy metal poisoning]] |
||
* |
*Spinal cord |
||
** |
**[[Acute transverse myelitis]] |
||
** |
**[[Acute spinal cord compression]] |
||
** |
**Trauma |
||
** |
**Infection |
||
* |
*Neuromuscular junction |
||
** |
**[[Myasthenia gravis]] |
||
* |
*Muscle |
||
** |
**[[Polymyositis]] |
||
** |
**[[Viral myositis]] |
||
** |
**[[Post-infectious myositis]] |
||
** |
**[[Critical illness myopathy]] |
||
* |
*Functional |
||
[[Category:Neurology]] |
[[Category:Neurology]] |
||
Revision as of 15:45, 21 August 2020
Differential Diagnosis
| Guillain-Barré syndrome | Paralytic poliomyelitis | |
|---|---|---|
| Fever | afebrile | febrile with myalgias |
| Progression | subacute, days to weeks | acute, peaks at 2-4 days |
| Neurological deficits | ascending, symmetric muscle weakness with decreased DTRs | asymmetric weakness with increased DTRs; proximal more than distal, and legs more than arms |
| Sensory changes | mild disturbances or paresthesias | none |
| CSF findings | minimal or no pleocytosis, but elevated protein (albuminocytologic dissociation) | pleocytosis with elevated protein, normal glucose (aseptic meningitis) |
- Infection
- Viral
- Picornaviridae
- Flaviviridae: West Nile virus, Japanese encephalitis, Tick-borne encephalitis
- Herpesviridae: CMV, EBV, VZV
- HIV-related opportunistic infections
- Rabies
- Bacteria
- Viral
- Neuropathy
- Guillain-Barré syndrome, though it is typically symmetrical and bilateral ascending paralysis that may include loss of sensation
- Acute motor axonal neuropathy
- Critical illness neuropathy
- Lead poisoning
- Other heavy metal poisoning
- Spinal cord
- Acute transverse myelitis
- Acute spinal cord compression
- Trauma
- Infection
- Neuromuscular junction
- Muscle
- Functional
