Acute flaccid paralysis is a syndrome resulting from a wide array of underlying conditions. The features are of a fairly rapidly progressing lower motor neurone pattern weakness with potential involvement not only of the limbs but also of muscles of the pharynx, trunk and diaphragm 1.
Historically poliomyelitis was the most common cause and many health authorities have ongoing reporting guidelines 3,4.
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Epidemiology
There are numerous causes of acute flaccid paralysis (see below) and these causes also vary dramatically between different populations. As such all ages and genders are affected, and these are discussed separately.
Clinical presentation
Patients presenting with acute flaccid paralysis have a rapid onset of quadriparesis or paraparesis with weakness reaching maximum severity over the course of several days to weeks, depending on the underlying cause (see below) 1.
Pathology
Aetiology
Causes of acute flaccid paralysis include 1:
- acute disseminated encephalomyelitis (ADEM)
- acute flaccid myelitis
- acute intermittent porphyria
- acute transverse myelitis
- Guillain-Barré syndrome (GBS) and variants
- hypokalaemic paralysis
- myasthenia gravis
- organophosphate poisoning
- poliomyelitis-like syndrome
- snake bite
- spinal cord tumours
- spinal cord compression
- spinal cord ischaemia
- tick bite paralysis
- viral meningoencephalitis
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