It has 3 serological forms affects mainly kids up to

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-by poliovirus, smalles known virus. It has 3 serological forms -affects mainly kids up to 5 yrs, rare in adults *Pathogenesis -affects CNS but penetrates the body via GIT -infection via fecal-oral or respiratory route -virus penetrates into bloodstream (viremia) and it disseminates into diff organs -incubation period is 7-12 days *Clinical presentation and classification *non-symptomatic form -most prevalent -patient is a carrier but doesn’t know it -no signs, only high antibody titre *Aborting form -non-specific respiratory and GIT infection (cough, diarrhea, vomiting, dyspepsia) -self-limmited *meningeal form(rare condition) -acute serous viral meningitis -signs of infection -meningeal signs -may be self-limited -requires only nonspecific treatment *neurologic form (most rare, involvement of CNS) -Pontine form: Facial N. (Bilateral paralysis of mimic muscles) -Bulbar form: patient is unable to swallow, speak, autonomic instability (may end fatal)
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-Spinal form: peripheral paralysis of extremities, flaccid peripheral tetraplegia -mixed form (progression is very rapid) *Stages of neurologic form -1 st preparalytic: may last +1 week, non-specific symptoms, general fatigue, GIT symptoms, subfebrile temp -2 nd paralytic: very rapid progression (1/2 day) peripheral paralysis of extremities, lasts for up to 1 month -3 rd stage of reconvalescence: lasts up to 6 months, slow disappearing of paralysis -4 th residual stage: lasts up to the end of patients life, limitation of ordinary activity, muscle contractions, osteoporosis with secondary fractures, trophic changes in soft tissues (trophic ulcers) *Diagnosis: -fasciculations as nonspecific symptom of infection -rapidly progressing peripheral paralysis -very acute condition -high titre of antibodies in blood -CSF: elevated protein, mild lymphocytic pleocytosis *Differential Diagnosis with ATM (acute transverse myelitis) -ATM: white matter vs Polio: ant. Horn of gray matter -ATM :central paralysis vs Polio: peripheral paralysis -ATM: motor, sens, auto signs vs Polio: only motor signs -ATM:autoimmune vs Polio: infectious disease *Treatment: *Acute stage: (start as soon as possible) -infusion of human immunglobulines -aggressive antiedematic therapy (corticosteroids+diuretics) -bulbar form: analeptics (camphor) -physical Rehabilitation *Chronic stage -4-5 months of rehab -cholinesterase inhibitors (Neostigmine) -alpha lipoc acid -anabolic steroids -metabolic treatment Naftidrofuryl *Prophylaxis: Vaccination n early childhood (Salk and Sabins Vaccine) 32. Neurological manifestations of Syphilis *Pathogenesis -occurs only after infection with syphilis and in the 3 rd stage of syphilis *Classification of stages: *Primary stage: develops 5-7 years after infection -involvement of connective tissues of brain and spinal cord leads to syphililiti meningitis, syphilitic meningoencephalitis, syphilitic gumma of the brain, syphilitic endoarteritis.
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  • Winter '18
  • Jane doe

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