Polio medical therapy: Difference between revisions
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== Medical Therapy== | == Medical Therapy== | ||
There is no antiviral drug, or other kind of treatment for neither form poliomyelitis. Current management of these patients is based on supportive care towards symptom relief.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | |||
===Supportive Care=== | |||
Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.<ref>{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | |||
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Paralysis of the respiratory muscles necessitates mechanical ventila- tion before hypoxia develops, generally when the vital capacity falls to less than 50%. Tank respirators used in the past to treat this form of paralysis are available in few hospitals; despite their advantage of avoid- ing tracheal intubation, they have been replaced by positive-pressure ventilators, which permit easier access to the patient. Pooling of secre- tions in the pharynx in mild bulbar poliomyelitis, if unaccompanied by spinal respiratory paralysis, can be managed with postural drainage and suction. Severe bulbar paralysis necessitates tracheal intubation. Weak- ness or paralysis of the bladder may necessitate catheterization. | Paralysis of the respiratory muscles necessitates mechanical ventila- tion before hypoxia develops, generally when the vital capacity falls to less than 50%. Tank respirators used in the past to treat this form of paralysis are available in few hospitals; despite their advantage of avoid- ing tracheal intubation, they have been replaced by positive-pressure ventilators, which permit easier access to the patient. Pooling of secre- tions in the pharynx in mild bulbar poliomyelitis, if unaccompanied by spinal respiratory paralysis, can be managed with postural drainage and suction. Severe bulbar paralysis necessitates tracheal intubation. Weak- ness or paralysis of the bladder may necessitate catheterization. | ||
Management of long-term physical and psychiatric sequelae of paralytic poliomyelitis is beyond the scope of this text. The reader is referred to excellent older references on these topics.54,55 | Management of long-term physical and psychiatric sequelae of paralytic poliomyelitis is beyond the scope of this text. The reader is referred to excellent older references on these topics.54,55 | ||
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No cure for polio exists, and the focus of modern polio treatment has been on increasing comfort, speeding recovery and preventing complications. Supportive measures include: [[antibiotics]] to prevent infections in weakened muscles, [[analgesics]] for pain, moderate exercise and a nutritious diet. Treatment of polio also often requires long-term rehabilitation including physical therapy, braces, corrective shoes and, in some cases, [[orthopedic surgery]]. | |||
Portable ventilators may be required to support breathing. Historically, a noninvasive negative-pressure ventilator (more commonly called an iron lung) was used to artificially maintain respiration during an acute polio infection until a person could breathe independently; generally about one to two weeks. Today many polio survivors with permanent respiratory paralysis use modern jacket-type negative-pressure [[ventilator]]s that are worn over the chest and abdomen. | |||
Other historical treatments for polio have included [[hydrotherapy]], [[electrotherapy]] and surgical treatments such as tendon lengthening and nerve grafting. The use of devices such as rigid braces and body casts—which tended to cause muscle atrophy due to the limited movement of the user—were also touted as effective treatments. Massage, passive motion exercises, and vitamin C were also used to treat polio victims, with varying degrees of success. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:37, 3 September 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Only treatment for symptoms is available, ranging from pain and fever relief to intubation and mechanical ventilation for patients with respiratory insufficiency.
Medical Therapy
There is no antiviral drug, or other kind of treatment for neither form poliomyelitis. Current management of these patients is based on supportive care towards symptom relief.[1]
Supportive Care
Hospitalization is indicated for acute cases of paralytic poliomyelitis, since bed rest prevents extension of paralysis. Pain and spasms may be relieved by application of host moist packs to the affected muscles. Once extension of paralysis has stopped, physical therapy should be initiated.[2]
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.