A PROSPECTIVE CLINICAL AND ELECTROPHYSIOLOGICAL SURVEY OF ACUTE FLACCID PARALYSIS IN PEDIATRIC PATIENTS

Electrophysiological Survey of Acute Flaccid Paralysis

Abstract

Objective: Recognition of common causes of acute flaccid paralysis in children.
Study Design: Descriptive study.
Place and Duration of Study: Combined Military Hospital Peshawar, from Aug 2009 to Jun 2012.
Material and Methods: The demographic data including age, gender and clinical data including history of injection, stool results, and final diagnosis (polio, non-polio enterovirus, traumatic injection neuritis, GBS and an unknown group) were expressed in terms of frequencies and percentages. Chi-square test was applied for the association of age-groups with various causes of AFP. A p-value of less than 0.05 was taken as statistically significant. SPSS version 20 was used for statistical analyses.
Results: Injection neuritis and post-viral paralysis (polio, non-polio enterovirus) were the common causes of AFP.
Conclusion: As the study identified common causes of AFP which are essentially  preventable, it highlighted certain issues during the process. First is the lack of nursing staff training or iatrogenic disability due to quackery, which requires urgent intervention to prevent it. Second is a deficiency in the WHO management protocol for AFP. NCS EMG proved to be a vital diagnostic tool for AFP, which is not included in the WHO AFP protocol at present.It is suggested that this diagnostic modality should be included in the AFP diagnostic protocol for better diagnostic yield.
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