Question

Laboratory evaluation of Acute Flaccid Paralysis.

Hint:

Early stool and throat samples are crucial for detecting viral causes like poliovirus or enterovirus, especially within the first two weeks of symptom onset.

Answer 1

Laboratory evaluation is essential to confirm the diagnosis, identify the causative agent, and rule out other possible causes of paralysis. The key laboratory tests include:
1. Viral Studies:
- Throat and stool samples: These are collected early (within 14 days of onset) and sent for viral culture, polymerase chain reaction (PCR), and sequencing to detect poliovirus or other enteroviruses.
- Cerebrospinal fluid (CSF) analysis: CSF should be collected to assess for signs of inflammation (pleocytosis) and rule out meningitis. PCR can be used to detect viral DNA or RNA, confirming viral etiology.
2. Blood Tests:
- Complete blood count (CBC): May show signs of infection or inflammation.
- Serological tests: Tests for antibodies to viruses (like enteroviruses or herpesviruses) can be performed to identify past infections or current viral replication.
3. Electromyography (EMG):
- Motor nerve conduction studies can assess the extent of motor nerve damage and aid in confirming the diagnosis of neuropathic vs. myopathic conditions.
4. Toxin Detection:
- In cases of suspected botulism, serum and stool samples should be tested for the botulinum toxin using toxicity assays.
5. Spinal Imaging:
- In cases of suspected spinal cord injury or neurological diseases, MRI of the spinal cord may be performed to rule out structural causes like tumors or infections.