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Medicine C.N.S. fb40602c

Which of the following is LEAST suggestive of infection with polio virus :

A
Low grade fever and malaise with complete resolution in 2 to 3 days
B
Biphasic illness with several days of fever, then meningeal symptoms and asymmetric flaccid paralysis 5 to 10 days later
C
Descending motor paralysis with preservation of tendon reflexes and sensation
D
Failure to isolate a virus from the cerebrospinal fluid in the presence of marked meningismus
High-Yield Explanation
Ans. is 'c' i.e Descending motor paralysis with preservation of Tendon reflexes and sensation. Characteristics of paralysis in polioIt is purely motor* affecting the Anterior horn cellsAsymmetric Flaccid paralysis DescendingLoss of reflexesMay involve respiratory musclesClinical manifestations of PoliomyelitisMost infections with poliomyelitis are asymptomatic and patients presents with minor illness which usually resolves in 3 daysAbout 1% of patient presents with Aseptic Meningitis (Non paralytic Poliomyelitis)Examination of C.S.F revealsPleocytosisNormal glucose levelSlightly elevated protein levelPoliovirus may not be detected in C.S.FLeast common presentation is that of Paralytic diseaseAfter 1 or several days of Aseptic meningitis rapid motor weakness develop and asymmetric flaccid paralysis occurs

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