Gear J H
Rev Infect Dis. 1984 May-Jun;6 Suppl 2:S379-84. doi: 10.1093/clinids/6.supplement_2.s379.
In a study of patients with suspected poliomyelitis, but from whom poliovirus was not isolated, a variety of causes of the paralysis was found. Injury of the spinal column sometimes followed by periostitis or osteomyelitis was relatively common. Exotic causes included paralysis due to snake bite, spider bite, scorpion sting, and tick bite and schistosomiasis involving the spinal cord. Chemical poisons, such as arsenic, triorthocresyl phosphate, and organophosphorus insecticides, were responsible for paralysis affecting groups of people. Paralysis in individual patients with porphyria followed the administration of anesthesia and certain drugs. Normal clinicopathologic findings in hospital nurses with Iceland disease suggested a psychological component. The Guillain-Barré syndrome in some patients resulted from virus infection of the nerve tissue, in others it was related to a hyperreactive autoallergic state. Enterovirus infections, especially coxsackieviruses A9 and A23 (echovirus 9) and group B coxsackieviruses, frequently caused meningoencephalitis often associated with transient paralysis. Coxsackievirus A7 infection occasionally resulted in permanent paralysis. Clearly it is important to maintain surveillance of these infections.
在一项针对疑似脊髓灰质炎但未分离出脊髓灰质炎病毒的患者的研究中，发现了多种导致瘫痪的原因。脊柱损伤有时伴有骨膜炎或骨髓炎，这种情况相对常见。其他罕见原因包括蛇咬、蜘蛛咬、蝎子蜇、蜱叮咬以及涉及脊髓的血吸虫病导致的瘫痪。化学毒物，如砷、磷酸三甲苯酯和有机磷杀虫剂，是导致人群瘫痪的原因。卟啉症患者个体在接受麻醉和某些药物后会出现瘫痪。冰岛病医院护士的临床病理检查结果正常，提示存在心理因素。一些患者的格林 - 巴利综合征是由神经组织病毒感染引起的，而在另一些患者中则与高反应性自身过敏状态有关。肠道病毒感染，尤其是柯萨奇病毒A9和A23（埃可病毒9）以及B组柯萨奇病毒，经常引起脑膜脑炎，常伴有短暂性瘫痪。柯萨奇病毒A7感染偶尔会导致永久性瘫痪。显然，对这些感染进行监测很重要。
