Wednesday, June 1, 2011

Polio - Diagnosis

Laboratory studies:Will make the spinal puncture with cerebrospinal fluid extraction, measure its pressure, pleocitoza (neutrophils and then lymphocytes in the early days) is described in installation paralysis after acute polio-CSF protein is slightly high but normal glucose, except in patients with severe paralysis showing proteinorahie than 100-300 mg / dL-Full blood count, as is leukocytosisVirus-detection in pharyngeal lavage, blood culture, CSF culture and seatSeat-viral studies are essential for the diagnosis of polio-Virus can be detected in the pharynx in the first chair in the first week and 2-5 weeks-In rare cases the virus can be isolated from serum or CSF, These tests require a 4-fold increase in antibody titer to specific diagnosisPolymerase chain-reaction is routinely used to differentiate strains of the virus in vaccines.
Imaging studies.Magnetic resonance show the location of previous inflammation in the spinal cord motor horn.Electromyography showed reduced recruitment pattern and decreased interference pattern involving motor axonal fibers.Fibrillation develops in 2-4 weeks and persist indefinitely, fasciculations may be seen as well. Motor unit action potentials of low amplitude is initially broad and then becomes high time.Polyphasic motor units are observed late due reinervarii. Motor driving speeds remain normal. Sensitive leadership remains normal.Histological examination. In previous microscopy horn cells are surrounded by inflammatory cells marrow. Note sponges gray matter, with numerous scattered inflammatory cells. Most inflammatory cells are neutrophils.The differential diagnosis is made with the following diseases: Guillain-Barre syndrome, West Nile virus, acute Meng, other motor polyneuropathy, acute intermittent porphyria, acute transverse myelitis, encephalitis, acute infections echovirusuri, Coxsackie virus, flaviviruses, HIV neuropathy, botulism, dystrophy myotonic.

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