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Flaccid paralysis

January 01, 1970

For the tactical shooting technique, see Flaccid paralysis (shooting).
"Flaccid" redirects here. For the states of the half-erect penis or clitoris tissues, see Tumescence.

Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause (e.g., trauma).[1] This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit flaccid paralysis. When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation. It also occurs in the spinal shock stage in complete transection of the spinal cord occurring in injuries such as gunshot wounds.[2]

Flaccid paralysis
Pronunciation
SpecialtyNeurology 

Causes edit

Polio and other viruses edit

See also: Acute flaccid myelitis

The term acute flaccid paralysis (AFP) is often used to describe an instance with a sudden onset, as might be found with polio.[3]

AFP is the most common sign of acute polio, and used for surveillance during polio outbreaks. AFP is also associated with a number of other pathogenic agents including enteroviruses other than polio, echoviruses, West Nile virus, and adenoviruses, among others.[4]

Botulism edit

The Clostridium botulinum bacteria are the cause of botulism. Vegetative cells of C. botulinum may be ingested. Introduction of the bacteria may also occur via endospores in a wound. When the bacteria are in vivo, they induce flaccid paralysis. This happens because C. botulinum produces a toxin that blocks the release of acetylcholine. Botulism toxin blocks the exocytosis of presynaptic vesicles containing acetylcholine (ACh).[2] When this occurs, the muscles are unable to contract.[5] Other symptoms associated with infection from this neurotoxin include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Botulism prevents muscle contraction by blocking the release of acetylcholine, thereby halting postsynaptic activity of the neuromuscular junction. If its effects reach the respiratory muscles, then it can lead to respiratory failure, leading to death.[6]

Curare edit

Curare is a plant poison derived from – among other species – Chondrodendron tomentosum and various species belonging to the genus Strychnos, which are native to the rainforests of South America. Certain peoples indigenous to the region – notably the Macushi – crush and cook the roots and stems of these and certain other plants and then mix the resulting decoction with various other plant poisons and animal venoms to create a syrupy liquid in which to dip their arrow heads and the tips of their blowgun darts. Curare has also been used medicinally by South Americans to treat madness, dropsy, edema, fever, kidney stones, and bruises.[7] Curare acts as a neuromuscular blocking agent that induces flaccid paralysis. This poison binds to the acetylcholine (ACh) receptors on the muscle, blocking them from binding to ACh. As a result, ACh accumulates within the neuromuscular junction, but since ACh cannot bind to the receptors on the muscle, the muscle cannot be stimulated. This poison must enter the bloodstream for it to work. If curare affects the respiratory muscles, then its effects can become life-threatening, placing the victim at risk for suffocation.[2]

Other edit

Flaccid paralysis can be associated with a lower motor neuron lesion. This is in contrast to an upper motor neuron lesion, which often presents with spasticity, although early on this may present with flaccid paralysis.[8]

Included in AFP's list are poliomyelitis (polio), transverse myelitis, Guillain–Barré syndrome, enteroviral encephalopathy,[9] traumatic neuritis, Reye's syndrome, etc.

An AFP surveillance programme is conducted to increase case yield of poliomyelitis. This includes collection of two stool samples within fourteen days of onset of paralysis and identification of virus, and control of the outbreak and strengthening immunization in that area.[citation needed][10]

Historical records from the 1950s, modern CDC reports, and recent analysis of patterns in India suggest that flaccid paralysis may be caused in some cases by oral polio vaccinations.[11][12]

Venomous snakes that contain neurotoxic venom such as kraits, mambas, and cobras can also cause complete flaccid paralysis.[13] Some chemical warfare nerve agents such as VX can also cause complete flaccid paralysis.[14]

In some situations, prominently in those of oriental descent[15] hyperthyroidism can affect the consumption and restoration equilibrium of potassium ions in neurons resulting in hypokalaemic paralysis.

References edit

  1. ^ Alberta Government Health and Wellness (2005) Acute Flaccid Paralysis Public Health Notifiable Disease Management Guidelines.
  2. ^ a b c Saladin, Kenneth S. Anatomy & Physiology: The Unity of Form and Function. McGraw-Hill. 6th Edition. 2012.
  3. ^ "GPEI-Polio + Prevention". Retrieved 2022-11-18.
  4. ^ Kelly H, Brussen KA, Lawrence A, Elliot E, Pearn J, Thorley B (June 2006). "Polioviruses and other enteroviruses isolated from faecal samples of patients with acute flaccid paralysis in Australia, 1996–2004". Journal of Paediatrics and Child Health. 42 (6): 370–6. doi:10.1111/j.1440-1754.2006.00875.x. PMID 16737480. S2CID 23585402.
  5. ^ "Disease Listing, Botulism, General Information – CDC Bacterial, Mycotic Diseases".
  6. ^ "flaccid paralysis – definition of flaccid paralysis in the Medical dictionary – by the Free Online Medical Dictionary, Thesaurus and Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved 2014-02-26.
  7. ^ "Curare – Chondrodendron tomentosum". Blueplanetbiomes.org. Retrieved 2014-02-26.
  8. ^ Javed, Kinaan; Daly, Daniel T. (2022), "Neuroanatomy, Lower Motor Neuron Lesion", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 30969636, retrieved 2022-11-18
  9. ^ Idris M, Elahi M, Arif A (Jan–Mar 2007). "Guillain Barre syndrome: the leading cause of acute flaccid paralysis in Hazara division". Journal of Ayub Medical College, Abbottabad. 19 (1): 26–8. PMID 17867475.
  10. ^ Tangermann, Rudolf (May 2017). "The critical role of acute flaccid paralysis surveillance in the Global Polio Eradication Initiative". International Health. 9 (3): 156–163. doi:10.1093/inthealth/ihx016.
  11. ^ "Public Health Dispatch: Acute Flaccid Paralysis Associated with Circulating Vaccine-Derived Poliovirus – Philippines, 2001". MMWR. Morbidity and Mortality Weekly Report. 50 (40): 874–5. October 12, 2001.
  12. ^ Vashisht, Neetu; Puliyel, Jacob; Sreenivas, Vishnubhatla (February 2015). "Trends in Nonpolio Acute Flaccid Paralysis Incidence in India 2000 to 2013". Pediatrics. 135 (Supplement 1): S16–S17. doi:10.1542/peds.2014-3330DD.
  13. ^ GJ Müller; H Modler; CA Wium; DJH Veale; C J Marks (October 2012). "Snake bite in southern Africa: diagnosis and management". Continuing Medical Education. 30 (10): 362–381. Retrieved 2 March 2015.
  14. ^ Sidell, Frederick R. (1997). "Chapter 5: Nerve Agents" (PDF). Medical Aspects of Chemical and Biological Warfare. p. 144ff.
  15. ^ Burrow, Gerard; Oppenheimer, Jack; Volṕe, Robert (1989). Thyroid function & disease. Philadelphia : W.B. Saunders. ISBN 9780721621906.

Further reading edit

  • "Progress towards poliomyelitis eradication, Nepal, 1996–1999". Relevé Épidémiologique Hebdomadaire. 74 (42): 349–53. October 1999. PMID 10895300.
  • Centers for Disease Control Prevention (CDC) (September 2002). "Acute flaccid paralysis syndrome associated with West Nile virus infection – Mississippi and Louisiana, July–August 2002". MMWR. Morbidity and Mortality Weekly Report. 51 (37). Centers for Disease Control and Prevention (CDC): 825–8. PMID 12353741.
  • Sejvar JJ, Leis AA, Stokic DS, Van Gerpen JA, Marfin AA, Webb R, Haddad MB, Tierney BC, Slavinski SA, Polk JL, Dostrow V, Winkelmann M, Petersen LR (July 2003). "Acute flaccid paralysis and West Nile virus infection". Emerging Infectious Diseases. 9 (7): 788–93. doi:10.3201/eid0907.030129. PMC 3023428. PMID 12890318.
  • Saeed M, Zaidi SZ, Naeem A, Masroor M, Sharif S, Shaukat S, Angez M, Khan A (2007). "Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan". BMC Infectious Diseases. 7: 6. doi:10.1186/1471-2334-7-6. PMC 1804272. PMID 17300736.

External links edit

 
Look up flaccid in Wiktionary, the free dictionary.

January 01, 1970
flaccid, paralysis, tactical, shooting, technique, shooting, flaccid, redirects, here, states, half, erect, penis, clitoris, tissues, tumescence, neurological, condition, characterized, weakness, paralysis, reduced, muscle, tone, without, other, obvious, cause. For the tactical shooting technique see Flaccid paralysis shooting Flaccid redirects here For the states of the half erect penis or clitoris tissues see Tumescence Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause e g trauma 1 This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles For example if the somatic nerves to a skeletal muscle are severed then the muscle will exhibit flaccid paralysis When muscles enter this state they become limp and cannot contract This condition can become fatal if it affects the respiratory muscles posing the threat of suffocation It also occurs in the spinal shock stage in complete transection of the spinal cord occurring in injuries such as gunshot wounds 2 Flaccid paralysisPronunciation ˈ f l ae k s ɪ d p e ˈ r ae l e s ɪ s SpecialtyNeurology Contents 1 Causes 1 1 Polio and other viruses 1 2 Botulism 1 3 Curare 1 4 Other 2 References 3 Further reading 4 External linksCauses editPolio and other viruses edit See also Acute flaccid myelitis The term acute flaccid paralysis AFP is often used to describe an instance with a sudden onset as might be found with polio 3 AFP is the most common sign of acute polio and used for surveillance during polio outbreaks AFP is also associated with a number of other pathogenic agents including enteroviruses other than polio echoviruses West Nile virus and adenoviruses among others 4 Botulism edit The Clostridium botulinum bacteria are the cause of botulism Vegetative cells of C botulinum may be ingested Introduction of the bacteria may also occur via endospores in a wound When the bacteria are in vivo they induce flaccid paralysis This happens because C botulinum produces a toxin that blocks the release of acetylcholine Botulism toxin blocks the exocytosis of presynaptic vesicles containing acetylcholine ACh 2 When this occurs the muscles are unable to contract 5 Other symptoms associated with infection from this neurotoxin include double vision blurred vision drooping eyelids slurred speech difficulty swallowing dry mouth and muscle weakness Botulism prevents muscle contraction by blocking the release of acetylcholine thereby halting postsynaptic activity of the neuromuscular junction If its effects reach the respiratory muscles then it can lead to respiratory failure leading to death 6 Curare edit Curare is a plant poison derived from among other species Chondrodendron tomentosum and various species belonging to the genus Strychnos which are native to the rainforests of South America Certain peoples indigenous to the region notably the Macushi crush and cook the roots and stems of these and certain other plants and then mix the resulting decoction with various other plant poisons and animal venoms to create a syrupy liquid in which to dip their arrow heads and the tips of their blowgun darts Curare has also been used medicinally by South Americans to treat madness dropsy edema fever kidney stones and bruises 7 Curare acts as a neuromuscular blocking agent that induces flaccid paralysis This poison binds to the acetylcholine ACh receptors on the muscle blocking them from binding to ACh As a result ACh accumulates within the neuromuscular junction but since ACh cannot bind to the receptors on the muscle the muscle cannot be stimulated This poison must enter the bloodstream for it to work If curare affects the respiratory muscles then its effects can become life threatening placing the victim at risk for suffocation 2 Other edit Flaccid paralysis can be associated with a lower motor neuron lesion This is in contrast to an upper motor neuron lesion which often presents with spasticity although early on this may present with flaccid paralysis 8 Included in AFP s list are poliomyelitis polio transverse myelitis Guillain Barre syndrome enteroviral encephalopathy 9 traumatic neuritis Reye s syndrome etc An AFP surveillance programme is conducted to increase case yield of poliomyelitis This includes collection of two stool samples within fourteen days of onset of paralysis and identification of virus and control of the outbreak and strengthening immunization in that area citation needed 10 Historical records from the 1950s modern CDC reports and recent analysis of patterns in India suggest that flaccid paralysis may be caused in some cases by oral polio vaccinations 11 12 Venomous snakes that contain neurotoxic venom such as kraits mambas and cobras can also cause complete flaccid paralysis 13 Some chemical warfare nerve agents such as VX can also cause complete flaccid paralysis 14 In some situations prominently in those of oriental descent 15 hyperthyroidism can affect the consumption and restoration equilibrium of potassium ions in neurons resulting in hypokalaemic paralysis References edit Alberta Government Health and Wellness 2005 Acute Flaccid Paralysis Public Health Notifiable Disease Management Guidelines a b c Saladin Kenneth S Anatomy amp Physiology The Unity of Form and Function McGraw Hill 6th Edition 2012 GPEI Polio Prevention Retrieved 2022 11 18 Kelly H Brussen KA Lawrence A Elliot E Pearn J Thorley B June 2006 Polioviruses and other enteroviruses isolated from faecal samples of patients with acute flaccid paralysis in Australia 1996 2004 Journal of Paediatrics and Child Health 42 6 370 6 doi 10 1111 j 1440 1754 2006 00875 x PMID 16737480 S2CID 23585402 Disease Listing Botulism General Information CDC Bacterial Mycotic Diseases flaccid paralysis definition of flaccid paralysis in the Medical dictionary by the Free Online Medical Dictionary Thesaurus and Encyclopedia Medical dictionary thefreedictionary com Retrieved 2014 02 26 Curare Chondrodendron tomentosum Blueplanetbiomes org Retrieved 2014 02 26 Javed Kinaan Daly Daniel T 2022 Neuroanatomy Lower Motor Neuron Lesion StatPearls Treasure Island FL StatPearls Publishing PMID 30969636 retrieved 2022 11 18 Idris M Elahi M Arif A Jan Mar 2007 Guillain Barre syndrome the leading cause of acute flaccid paralysis in Hazara division Journal of Ayub Medical College Abbottabad 19 1 26 8 PMID 17867475 Tangermann Rudolf May 2017 The critical role of acute flaccid paralysis surveillance in the Global Polio Eradication Initiative International Health 9 3 156 163 doi 10 1093 inthealth ihx016 Public Health Dispatch Acute Flaccid Paralysis Associated with Circulating Vaccine Derived Poliovirus Philippines 2001 MMWR Morbidity and Mortality Weekly Report 50 40 874 5 October 12 2001 Vashisht Neetu Puliyel Jacob Sreenivas Vishnubhatla February 2015 Trends in Nonpolio Acute Flaccid Paralysis Incidence in India 2000 to 2013 Pediatrics 135 Supplement 1 S16 S17 doi 10 1542 peds 2014 3330DD GJ Muller H Modler CA Wium DJH Veale C J Marks October 2012 Snake bite in southern Africa diagnosis and management Continuing Medical Education 30 10 362 381 Retrieved 2 March 2015 Sidell Frederick R 1997 Chapter 5 Nerve Agents PDF Medical Aspects of Chemical and Biological Warfare p 144ff Burrow Gerard Oppenheimer Jack Volṕe Robert 1989 Thyroid function amp disease Philadelphia W B Saunders ISBN 9780721621906 Further reading edit Progress towards poliomyelitis eradication Nepal 1996 1999 Releve Epidemiologique Hebdomadaire 74 42 349 53 October 1999 PMID 10895300 Centers for Disease Control Prevention CDC September 2002 Acute flaccid paralysis syndrome associated with West Nile virus infection Mississippi and Louisiana July August 2002 MMWR Morbidity and Mortality Weekly Report 51 37 Centers for Disease Control and Prevention CDC 825 8 PMID 12353741 Sejvar JJ Leis AA Stokic DS Van Gerpen JA Marfin AA Webb R Haddad MB Tierney BC Slavinski SA Polk JL Dostrow V Winkelmann M Petersen LR July 2003 Acute flaccid paralysis and West Nile virus infection Emerging Infectious Diseases 9 7 788 93 doi 10 3201 eid0907 030129 PMC 3023428 PMID 12890318 Saeed M Zaidi SZ Naeem A Masroor M Sharif S Shaukat S Angez M Khan A 2007 Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan BMC Infectious Diseases 7 6 doi 10 1186 1471 2334 7 6 PMC 1804272 PMID 17300736 External links editWHO Programme for Immunization Preventable Diseases IPD A Collaboration between World Health Organization and Government of Nepal nbsp Look up flaccid in Wiktionary the free dictionary Retrieved from https en wikipedia org w index php title Flaccid paralysis amp oldid 1189328553, wikipedia, wiki, book, books, library,

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