Acute flaccid paralysis: Difference between revisions

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

Revision as of 11:45, 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)
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