Poliomyelitis - new problems with an old disease

Article Abstract:

Although the after-effects of polio were described over 100 years ago, patients experiencing its effects had great difficulty convincing doctors that new problems were developing 25 to 30 years after the original attack. The complaints of these patients were not taken seriously by the physicians. Finally the medical establishment could no longer ignore the obvious, and diagnostic criteria were established, the causes reviewed, and research priorities established. Post-polio syndrome is an organic disorder of the motor unit, and the 250,000 to 300,000 survivors of the polio epidemic of the 1950s are still at risk. The syndrome is the result of new and progressive denervation (destruction of the nerves signalling the muscles), and even muscles showing no evidence of disease are involved. The motor neurons are unstable and damage continues to occur, resulting in a slowly progressing loss of muscle power. In the April 25, 1991 issue of the New England Journal of Medicine, Barbara Sonies and Marinos Dalakas show that the bulbar muscles in the nose and throat, which affect breathing and swallowing, are also affected by this process. The most common theories are that it is a result of the normal aging process or excessive use, but neither of these theories stands up to scrutiny. The most likely cause is either an immunologic or inflammatory event that affects most, perhaps all, of the muscles previously damaged by polio. Fortunately, no major new progressive muscular deterioration results. Exercise programs are beneficial, and patients can be assured that they will not return to their previous state of disability. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Poliomyelitis, editorial

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A 32-year-old man with the sudden onset of a right-sided headache and left hemiplegia and hemianesthesia

Article Abstract:

The case of a patient with a history of high blood pressure and cocaine and alcohol use who developed a cerebral hemorrhage and cerebral vasculitis is discussed. Cerebral vasculitis is the inflammation of blood vessels in the brain. A 32-year-old man developed a headache on the right side of his head and then collapsed at a party. He was taken to a hospital, and when he arrived he had high blood pressure, a rapid pulse and paralysis of his left side. A computed tomographic (CT) scan of his head showed a hemorrhage on the right side. His urine tested positive for cocaine and opiates. On his third and fourth days in the hospital the patient became less alert. This decrease in alertness continued until the fifth day when another CT scan showed an increase in the pressure on the brain as the result of the hemorrhage. The patient underwent exploratory surgery and it was noted that not only was a hemorrhage present, but also cerebral vasculitis. Both disorders may have been independently related to cocaine abuse.

Physiological aspects, Brain, Brain hemorrhage, Cocaine abuse, Vasculitis, Hemiplegia

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A 70-year-old man with progressive muscle weakness and agitated depression

Article Abstract:

A 70-year-old man died after developing motor neuron disease. Motor neuron disease is a degenerative disorder that can be characterized by progressive wasting of muscle tissue. The patient was admitted to the hospital suffering from muscle weakness and agitated depression. He had been suffering from diabetes mellitus for seven years before being admitted to the hospital. He had started experiencing muscle weakness 11 months before admission. He had also begun experiencing panic attacks and suicidal thoughts before being admitted to the hospital. His blood pressure was low and he nearly fainted on the sixth hospital day. He died on the ninth hospital day after becoming unable to breath on his own. An autopsy of the brain and spinal cord and examination of nerve and muscle samples revealed that the patient had been suffering from motor neuron disease.

Nervous system, Nerve degeneration, Nervous system diseases

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