Poliomyelitis: Treatment
Last reviewed: 23.04.2024
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Patients with poliomyelitis (and even with suspected poliomyelitis) are subject to emergency isolation in specialized departments or boxes. There is no specific antiviral treatment for poliomyelitis. Absolute rest is mandatory in the preparative and paralytic periods, as any physical load accelerates development and increases the severity of paralysis. Treatment of poliomyelitis consists of the introduction of interferon alpha-2 (interferon), normal human immunoglobulin, ribonuclease. Disintoxication and dehydration treatment of poliomyelitis is carried out. Prescribed vitamins and pain killers, metamizole sodium. When paralyzes apply hot wraps, poultices. For 30 days, appoint bendazole (dibazol) at a rate of 1 mg / kg (has a positive effect on the function of the spinal cord) and ascorbic acid to 0.5-1.0 g / kg (stops the development of paralysis). When breathing disorders are carried out ventilation, sanation of the oropharynx and respiratory tract. When swallowing disorders - a probe feeding. Orthopedic correction is mandatory: orthopedic regimen is required to ensure the physiological position of the limb (up to the use of gypsum longites). Apply anticholinesterase drugs (proserine, oxazil, galantamine) courses for 10-20 days, if necessary alternating courses. In the recovery period, anabolic hormones (retabolyl, methandrostenolone), vitamins B (B1, B6 and B12), nicotinic acid, cocarboxylase, nootropic drugs are prescribed. To improve muscle function, phosphorus, potassium, and physiotherapy methods are used (ultra-high-frequency therapy, calcium chloride electrophoresis, potassium iodide, bromine, paraffin applications, diathermy). Physiotherapeutic treatment of poliomyelitis is carried out courses lasting 1-1.5 months. The purpose of massage and exercise is possible after the normalization of body temperature and the disappearance of symptoms of general intoxication and pain. Six months after the acute period, spa treatment is indicated. In the residual period, orthopedic and surgical correction is performed to treat residual events. The effectiveness of drug therapy is not evaluated by evidence-based therapy.
Prognosis for poliomyelitis
The prognosis of poliomyelitis is favorable for inapparant and abortive forms of poliomyelitis. Heavy course with lethal outcomes with meningeal form is possible, but extremely rare; subsequent long-term complications, as a rule, do not happen.
The outcome of the paralytic form of poliomyelitis depends on the severity of the CNS lesion. With timely and proper treatment, restoration of functions without consequences occurs in a third of cases. In about 30% of cases, polio ends with persistent residual paralysis with muscle atrophy leading to disability, 30% with mild paresis. About 10% of cases (with the defeat of the respiratory system) result in the death of patients. In case of severe bulbar paralysis, lethality reaches 60% (death may occur in a few days after paralysis of the respiratory center).
Approximate terms of incapacity for work
The period of disability depends on the clinical form of the infection. Inpatient treatment with meningeal form lasts up to 3-4 weeks, with paralytic treatment up to several months. The discharge is made after complete clinical recovery and in the absence of changes in the cerebrospinal fluid. Rehabilitation treatment in specialized sanatoria of the neurological profile was recommended.
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Clinical examination
Poliomyelitis does not require follow-up care for those who are sick and not regulated. The timing of monitoring patients is determined individually, but with meningeal and paralytic forms are at least a year.
What should the patient know about poliomyelitis?
Recommendations are given individually, are reflected in the statement and usually include:
- balanced diet;
- avoid hypothermia and other stress conditions;
- limitation of considerable physical exertion.
After the transferred meningeal and paralytic forms during the year, flights on the plane, hiking, diving (diving), vaccination, except for emergency (for example, against rabies) are excluded.