Question

Etiology of Acute Flaccid Paralysis.

Hint:

Poliovirus and enterovirus infections remain the leading causes of acute flaccid paralysis, particularly in regions with low vaccination rates.

Answer 1

Acute Flaccid Paralysis (AFP) is characterized by sudden-onset weakness or paralysis, usually affecting the limbs, with associated reduced or absent reflexes. The common etiologies of AFP include:
1. Viral Infections:
- Poliovirus: Historically the most common cause of AFP, particularly in unvaccinated populations.
- Enterovirus (EV71): This virus is also a significant cause, often associated with outbreaks of hand, foot, and mouth disease.
- Other viruses: Adenoviruses, herpesviruses (like Herpes simplex virus), and Zika virus have also been associated with AFP.
2. Bacterial Infections:
- Guillain-Barré syndrome (GBS): An autoimmune disease triggered by bacterial or viral infections, particularly Campylobacter jejuni, leading to ascending paralysis.
- Tetanus: Though rare, Clostridium tetani infection can cause AFP through neurotoxin release.
3. Toxic Causes:
- Botulism: Caused by *Clostridium botulinum* neurotoxin, it results in descending flaccid paralysis and is a critical differential diagnosis for AFP.
4. Other Causes:
- Neuromuscular disorders: Disorders like myasthenia gravis or spinal cord trauma can mimic AFP but are less common.
- Metabolic conditions: Some metabolic conditions (e.g., hypokalemi can cause flaccid paralysis.