What are the methods for differential diagnosis of poliomyelitis?

Although the incidence of diseases like polio is not high in life, once such a disease occurs, it will seriously affect the health of children and it is easy to leave some sequelae. Such a disease is very scary. I hope that parents can make a timely diagnosis after their children become ill and take their children for examination and treatment in time. So what are the methods for differential diagnosis of polio? Let’s introduce them in detail below.

Poliomyelitis, also known as poliomyelitis, is an acute infectious disease caused by the polio virus. The main clinical manifestations are fever, sore throat and limb pain, and some patients may develop flaccid paralysis. During epidemics, most cases are latent infection and no paralysis. The incidence rate in children is higher than that in adults. Before the universal vaccination, infants and young children were particularly prone to the disease, so it is also called infantile paralysis. The main lesions are in the gray matter of the spinal cord, and those with severe damage may have paralysis sequelae. Since the widespread use of vaccines to prevent this disease in the late 1950s, its incidence has dropped significantly. After smallpox was eradicated in the 1970s, polio has been set as the next target to be eradicated by the end of this century.

The prodromal stage should be differentiated from common upper respiratory tract infections, influenza, gastroenteritis, etc. Patients in the pre-paralysis stage should be differentiated from various viral encephalitis, purulent meningitis, tuberculous meningitis, and epidemic encephalitis B. The appearance of flaccid paralysis is helpful for diagnosis. It also needs to be differentiated from the following diseases:

(I) Infectious polyradiculitis or Guillain-Barre's syndrome is more common in older children. It starts sporadically, with no fever or low fever, accompanied by mild upper respiratory tract symptoms, and gradually develops flaccid paralysis, which is ascending and symmetrical, often accompanied by sensory impairment. It is characterized by increased protein and fewer cells in the cerebrospinal fluid. Paralysis recovers quickly and completely, with few sequelae.

(ii) Familial periodic paralysis is less common, afebrile, sudden onset, symmetrical, and progresses rapidly, and can spread throughout the body. During an attack, blood potassium is low, and it recovers quickly after potassium supplementation, but it can recur. There is often a family history.

(III) Peripheral neuritis can be caused by post-diphtheria neuritis, intramuscular injection injury, lead poisoning, vitamin B1 deficiency, herpes zoster infection, etc. Medical history and physical examination can be used for differentiation, and there is no change in cerebrospinal fluid.

(IV) Other viral infections that cause mild paralysis, such as coxsackievirus and echovirus infections, are difficult to differentiate clinically. Typical symptoms such as chest pain and rash can help differentiate them. Confirmation depends on virus isolation and serological examination.

(V) Epidemic Japanese encephalitis should be differentiated from the encephalitis type of this disease. Japanese encephalitis often occurs in summer and autumn, with an acute onset and often accompanied by mental disorders. The main symptom in peripheral blood and cerebrospinal fluid is an increase in neutrophils.

(VI) Pseudoparalysis: Infants and young children may have limited limb movement due to injury, fracture, arthritis, or subperiosteal hematoma caused by vitamin C deficiency, and should be carefully examined and identified.

This is an introduction to the methods of differential diagnosis of polio. If parents can understand the methods of differential diagnosis of polio, it can help children to get a timely diagnosis and take timely treatment measures when they are sick, avoid unnecessary harm, and get the greatest degree of recovery. Therefore, it is necessary for parents to understand the basic knowledge of polio in their daily lives.