Acute Flaccid Paralysis

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Clinical Description

Acute onset of weakness or paralysis with reduced muscle tone

Causes:

  • Inflammatory: Guillain- Barre syndrome, Transverse myelitis
  • Trauma
  • Infection: e.g. TB spine, schistosomiasis, enteroviruses, polio 
  • Tumours: primary or secondary spinal tumours e.g. Burkitt’s Lymphoma
  • Toxins: botulinum toxin

Clinical FeaturesSIGNS AND SYMPTOMS

  • Rapid onset of weakness, Ascending weakness, Paraplegia, Bulbar weakness, Paresthesia, Stool and urine incontinence, Radicular pain, Autonomic dysfunction 

INVESTIGATIONS

  • Identify underlying cause, Xray of spine, Stool and urine microscopy, CT or MRI spine

Treatment

Objective

  • Prevent respiratory and cardiovascular compromise and restore function of the spinal cord
  • Assess and manage airway, Breathing and Circulation
  • Refer urgently if ascending paralysis
  • Physiotherapy and occupational therapy
  • Treat underlying cause

Complications

  • Respiratory failure, Spinal shock, Pressure sores, Contractures

REFERRAL

  • Refer urgently if ascending paralysis
  • Refer all for diagnostic workup