Date: Wed, 5 Apr 2000 21:06:02 -0400
From: "Eddie Bollenbach" <edward.bollenbach @ snet.net>
Subject: [PPM] Paralytic and Non-Paralytic Polio

Here is the definition of non-paralytic polio:

Symptoms include headache, neck, back, and limb pain. Fever, vomiting, abdominal pain, lethargy, and irritability. Muscle spasm seems to "always" be present in the neck and back, usually in the hamstring muscles, and variably present in other muscles. Muscles are generally tender to the touch.

There is no paralysis evident. Paralysis means some muscles are soft (flaccid) and cannot be contracted. This is the "nub" of the definition of paralytic polio. Some muscles are unable to be contracted or moved and are soft.

For paralytic polio let me address some of the comments and questions expressed about this category of polio:

First, the symptoms include everything written above but also some muscles lose tone and are flaccid. There are several categories of paralytic polio based on which muscles/nerves are affected.

To wit:

1. Spinal paralytic polio is when muscles are affected which are supplied by spinal nerves. This includes most of the muscles of the body: Legs, Trunk, Arms etcetera.

2. Bulbar paralytic polio is accompanied by weakness of muscles supplied by the cranial nerves which may affect swallowing, breathing, facial muscles, tongue etcetera. Bulbar polio and spinal polio often coexist. They are both a subclass of paralytic polio

If you have paralytic polio it does not mean the limb will remain paralyzed for life. Often there is very good recovery from paralytic polio. Sometimes there is not. Indeed, PPS can result in a very big loss of function if recovery was impressive after the acute illness, and then lost during PPS.

So paralytic polio is not only in those cases where there is permanent paralysis of a limb. Paralytic polio includes Bulbar polio if the muscles paralyzed are innervated by cranial nerves. The second misconception is that it does not have to be permanent. One can have had paralytic polio and recover seemingly normal function. People have had paralytic polio and gone on to become world class athletes eg. Sonja Henle, an olympic skater. So the paralysis is certainly not always permanent.

Another misconception is that non-paralytic is not when the person doesn't know they had polio. This is only true sometimes. Non-Paralytic polio was a diagnosis based on the criteria above. Many people know they were diagnosed with non-paralytic polio.

If you bite your tongue, mouth, can't chew gum etcetera it means you had bulbar polio because those nerves damaged are cranial nerves which stimulate those affected muscles (cranial means they come out of the head and not off the spine, rather from the back of the brain) --the bulb of the brain--hence bulbar. But since those muscles have a degree of paralysis you had paralytic polio. I don't think these terms should be used loosely because they have specific meanings and represent diagnostic categories of polio.

Eddie
Contact Professor Edward P. Bollenbach
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