poliomyelitislike

Poliomyelitislike is a descriptive term for illnesses that resemble poliomyelitis in clinical presentation but are not caused by poliovirus. The core feature is acute, focal, asymmetric flaccid paralysis, often in one or a few limbs, with reduced reflexes and little sensory loss. A preceding fever or viral illness is common.

Most cases fall under acute flaccid myelitis (AFM), a syndrome in children linked to nonpolio enteroviruses such as EV-D68 and EV-A71. Other nonpolio enteroviruses, adenoviruses, and, less often, autoimmune or inflammatory processes can produce polio-like paralysis. Poliovirus testing is used to exclude polio.

Diagnosis involves neurologic examination, spinal MRI showing gray-matter–predominant lesions in AFM, and CSF analysis with mild pleocytosis. Virology testing targets enteroviruses; poliovirus testing is essential to rule out polio.

Management is supportive: respiratory support if needed, pain control, and intensive rehabilitation. There is no proven antiviral treatment for AFM; immunomodulatory therapies (for example IVIG or steroids) are used selectively and without proven benefit in many settings, depending on the presumed cause.

Prognosis is variable; many patients retain some weakness, though function may improve with time and rehabilitation. Epidemiology emphasizes distinguishing polio from nonpolio causes during surveillance for acute flaccid paralysis.