Acute Flaccid paralysis is a clinical manifestation characterized by weakness or paralysis and reduced muscle tone without other obvious cause.
Etiology
Acute Flaccid Paralysis (AFP) may be caused by a number of agents including enterovirus, echovirus or adenovirus. Acute West Nile infection and campylobacter have also been associated with AFP.
Clinical Presentation
Focal weakness or paralysis characterized as flaccid (reduced tone) without other obvious cause (e.g., trauma) in children less than 15 years old.
Causes
Polio
The term acute flaccid paralysis (AFP) is often used to describe a sudden onset, as might be found with polio.
AFP is the most common sign of acute polio, and used for surveillance during polio outbreaks. AFP is also associated with a number of other pathogenic agents including enteroviruses, echoviruses, and adenoviruses, among others.
Botulism
The Clostridium botulinum bacteria are the cause of botulism. Vegetative cells of C. botulinum may be injested. Introduction of the bacteria may also occur via endospores in a wound. When the bacteria is in vivo they induce flaccid paralysis. This happens because C. botulinum produces a toxin which blocks the release of acetylcholine. When this occurs, the muscles are unable to contract.
Other
Flaccid paralysis can be associated with a lower motor neurone lesion. This is in contrast to a upper motor neurone lesion, which often presents with spastic paralysis. Included in AFP,s list are Poliomyelitis, Transverse myelitis,Guillain-Barré syndrome, enteroviral encephalopathy, traumatic neuritis etc. An AFP Surveillance programme is conducted to increase case yield of poliomyelitis. This includes collection of 2 stool samples within 14 days of onset of paralysis and identification of virus and control of the outbreak and strenghthening immunisation in that area.
Diagnosis
Surveillance is conducted in an attempt to identify cases of AFP (including GBS, transverse myelitis, myelopathy, West Nile virus infection, etc.) and to investigate all reported cases for evidence to rule out or to confirm paralytic poliomyelitis.
source click here
