Kaushik Rupesh, Kharbanda Parampreet S, Bhalla Ashish, Rajan Roopa, Prabhakar Sudesh
Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.
J Emerg Trauma Shock. 2014 Jul;7(3):149-54. doi: 10.4103/0974-2700.136847.
Acute flaccid paralysis (AFP) is a complex clinical syndrome with a broad array of potential etiologies that vary with age. We present our experience of acute onset lower motor neuron paralysis.
One hundred and thirty-three consecutive adult patients presenting with weakness of duration less than four weeks over 12 months period were enrolled. Detailed history, clinical examination, and relevant investigations according to a pre-defined diagnostic algorithm were carried out. The patients were followed through their hospital stay till discharge or death.
The mean age was 33.27 (range 13-89) years with male preponderance (67.7%). The most common etiology was neuroparalytic snake envenomation (51.9%), followed by Guillain Barre syndrome (33.1%), constituting 85% of all patients. Hypokalemic paralysis (7.5%) and acute intermittent porphyria (4.5%) were the other important conditions. We did not encounter any case of acute polio mylitis in adults. In-hospital mortality due to respiratory paralysis was 9%.
Neuroparalytic snakebite and Guillain Barre syndrome were the most common causes of acute flaccid paralysis in adults in our study.
急性弛缓性麻痹(AFP)是一种复杂的临床综合征,潜在病因广泛,且随年龄而异。我们介绍了急性起病的下运动神经元麻痹的经验。
纳入133例连续的成年患者,这些患者在12个月内出现持续时间少于4周的肌无力症状。根据预先定义的诊断算法进行详细的病史询问、临床检查及相关检查。对患者进行住院期间的随访直至出院或死亡。
平均年龄为33.27岁(范围13 - 89岁),男性占优势(67.7%)。最常见的病因是神经麻痹性蛇咬伤(51.9%),其次是吉兰 - 巴雷综合征(33.1%),这两种病因占所有患者的85%。低钾性麻痹(7.5%)和急性间歇性卟啉病(4.5%)是其他重要病因。我们未遇到任何成人急性脊髓灰质炎病例。因呼吸麻痹导致的住院死亡率为9%。
在我们的研究中,神经麻痹性蛇咬伤和吉兰 - 巴雷综合征是成人急性弛缓性麻痹最常见的病因。