Details
Category: Volume 09 Issue 02 February 2021
Hits: 875

Title: Clinico- etiological study on acute flaccid paralysis in adults in a rural tertiary referral centre of West Bengal

Authors: Sumit Sarkar, Shrinwanti Karmakar, Prasenjit Sengupta, Debal Laha, Alak Pandit

 DOI: https://dx.doi.org/10.18535/jmscr/v9i2.38

Abstract

Background and Objectives: Various studies are available regarding acute flaccid paralysis in the paediatric population regarding AFP prevalence. However, few such studies have been conducted among adults. Our aim was to study the underlying causes of acute flaccid paralysis (AFP) in adults, to study the various clinical presentation of AFP in adults, and to study the outcome of these adult patients presenting with AFP.

Methods: 100 patients presenting with acute flaccid weakness in adults more than 15 years and duration less than 4 weeks were clinically examined with proper history, followed by detailed blood tests, CSF study in selected patient, and Electrodiagnostic testing.

Results: In our study we found Hypokalemic paralysis is the most common etiology of AFP. There is male preponderance and significant seasonal variation, predominant during summer. It also shows that GB syndrome is predominant in young patient where as Hypokalemic paralysis is predominant after third decade. There are 4 deaths out of 100 AFP patients

Interpretation and Conclusion: This is one of the few studies on Acute Flaccid Paralysis in adult from Eastern India- on their etiologies and clinical features. There was no much difference in the clinical profile of the patients of AFP in our study as compared to most of the previous studies. Larger sample size and longer duration of follow-up is necessary to identify other conditions causing acute flaccid paralysis and their long-term outcomes.

Keywords:  AFP, Quadriparesis, Paraparesis, Hypokalemic paralysis, GB syndrome.

References

  1. Ward NA, Milstien JB, Hull HF, Hull BP, Kim-Farley RJ. The WHO-EPI initiative for the global eradication of poliomyelitis. 1993; 21:327–33.
  2. Morris AM, Elliott EJ, D’Souza RM, Antony J, Kennett M, Longbottom H. Acute flaccid paralysis in Australian children. J Paediatr Child Health. 2003; 39:22–
  3. Molinero MR, Varon D, Holden KR, Sladky JT, Molina IB, Cleaves F. Epidemiology of childhood Guillain-Barré syndrome as a cause of acute flaccid paralysis in Honduras: 1989-1999. J Child Neurol. 2003;18:741–108
  4. Ashok K Kayal, Munindra Goswami, Marami Das, Rahul Jain, Clinical and biochemical spectrum of hypokalemic paralysis in North: East India, Year : 2013 | Volume : 16 | Issue : 2 | Page : 211-217
  5. Soysal A, Aysal F, Caliskan B, Dogan Ak P, Mutluay B, Sakalli N, et al. Clinico-electrophysiological findings and prognosis of Guillain-Barré syndrome--10 years’ experience. Acta Neurol Scand. 2011;123:181–
  6. Arami MA, Yazdchi M, Khandaghi R. Epidemiology and characteristics of Guillain-Barré syndrome in the northwest of Iran. Ann Saudi Med. 2006; 26:22–7
  7. Lin SH, Lin YF, Halperin ML. Hypokalemia and paralysis. QJM 2001; 94:133-9.
  8. Arya SN. Periodic paralysis. JIACM 2002; 3:374-82
  9. Rao N, John M, Thomas N, Rajaratnam S, Seshadri MS. Aetiological, clinical and metabolic profile of hypokalaemic periodic paralysis in adults: A single-centre experience. Natl Med J India 2006;19:246-9.
  10. Maurya PK, Kalita J, Misra UK. Spectrum of hypokalaemic periodic paralysis in a tertiary care centre in India. Postgrad Med J 2010;86:692-5.
  11. Rupesh Kaushik et al., Acute Flaccid paralysis in adults: Our experience, J Emerg Trauma Shock. 2014 Jul-Sep; 7(3): 149–
  12. Pal PK, Vengamma B. Atypical neurological manifestations of hypokalemia. Ann Indian Acad Neurol 2004;7:375-80. 109
  13. Halawa EF, Ahmed D, Nada MA. Guillain-Barré syndrome as a prominent cause of childhood acute flaccid paralysis in post polio eradication era in Egypt. Eur J Paediatr Neurol. 2011;15:241–
  14. Durand MC, Porcher R, Orlikowski D, Aboab J, Devaux C, Clair B, et al. Clinical and electrophysiological predictors of respiratory failure in Guillain- Barré syndrome: A prospective study. Lancet Neurol. 2006;5:1021–
  15. Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S. Snake envenomation in a north Indian hospital. Emerg Med J. 2005;22:118–20
  16. Hadden RD, Cornblath DR, Hughes RA, et al. Electrophysiological classification of Guillain-Barré syndrome: clinical associations and outcome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group. Ann Neuro. 1998 Nov;44(5):780–788
  17. Tan HH. Epidemiology of snakebites from a general hospital in Singapore: A 5-year retrospective review (2004-2008) Ann Acad Med Singapore. 2010;39:640–

Corresponding Author

Dr Debal Laha