Cerebral: Bilateral strokes, Hysteria…
Cerebellar: Acute cerebellar ataxia syndromes.
Spinal: Compressive myolopathy, Transverse
Peripheral nerve: Acute inflammatory demyelinating
neuropathy, Toxic neuropathy, Diphtheria,
Neuromuscular junction: Botulism, Myasthenia Gravis…
Muscle disease: Acute myositis
Acute inflammatory myopathies
Acute Flaccid Paralysis
The sudden onset of generalized flaccid weakness in the absence of symptoms of encephalopathy implicates the motor unit.
AFP is an emergency in which management priorities are to support vital functions and reach a specific diagnosis in a timely manner with a focused history and physical examination.
It is an acute idiopathic monophasic acquired inflammatory demyelinating polyradiculoneuropathy.
GBS is the most common cause of acute flaccid paralysis in healthy infants and children.
Immune mediated disease.
There is no known genetic factors.
Two third of cases follow a respiratory or GI infection.
Campylobacter infection is the most common, but other organisms include CMV, EBV, HSV, Enteroviruses,…
Guillain-Barré syndrome has been reported to follow
The main lesions are acute inflammatory demyelinating polyradiculopathy, with acute axonal degeneration in some cases, particularly those following campylobacter infection.
Avariety of autoantibodies to gangliosides have been identified especially with axonal forms of the disease.
Usually 2 - 4 weeks following respiratory or GI infection.
The classic presentation:
Fine paresthesias in the toes and fingertips.
Lower extremity weakness: symmetric & ascending.
Inability to walk.
Respiratory muscles involvement.
Neuropathic pain… low back pain.
Facial nerve is most commonly affected, resulting in
bilateral facial weakness..