Question

Management of Acute Flaccid Paralysis.

Hint:

Early supportive care, including pain management and physical therapy, is critical to prevent complications and improve recovery outcomes in AFP.

Answer 1

The management of Acute Flaccid Paralysis (AFP) is multidisciplinary, focusing on the identification of the underlying cause, supportive care, and preventing complications. Key aspects of management include:
1. Supportive Care:
- Airway management: Some patients may require ventilatory support if respiratory muscles are involved.
- Pain management: Analgesics and muscle relaxants are used to control pain and spasticity.
- Physical therapy: Early rehabilitation is essential to prevent muscle atrophy, improve function, and enhance recovery.
2. Antiviral Treatment:
- For enteroviral infections, there is no specific antiviral therapy, but supportive care and hydration are essential.
- For botulism, botulinum antitoxin should be administered as soon as possible to prevent further toxin effects. Antibiotics may also be given if a bacterial source is identified.
- In Guillain-Barré syndrome (GBS), intravenous immunoglobulin (IVIG) or plasmapheresis can be used to modulate the immune response and prevent further nerve damage.
3. Botulism Management:
- In cases of botulism, besides antitoxin therapy, wound care and supportive treatments such as respiratory support and nutritional management are essential.
4. Monitoring and Prognosis:
- Patients with AFP should be monitored for complications such as respiratory failure or autonomic instability. The prognosis depends on the underlying cause—patients with viral or toxic causes may recover fully, while those with more severe etiologies, like GBS, may require prolonged rehabilitation.
5. Vaccination:
- For poliovirus-related AFP, vaccination is critical for prevention. Children should receive the full course of the polio vaccine to prevent future outbreaks.