Polio is an ancient disease. Involvement of anterior horn cells due to viral infection is the pathological mechanism underlying this condition. It remains to be a clinical diagnosis because most of the time, stool cultures are negative for poliovirus. Recent advances in magnetic resonance imaging may be helpful in establishing a definite diagnosis of poliomyelitis in addition to a clinical picture consistent with polio.
A 28-year-old man was admitted to the hospital with a 4-day history of progressive weakness and low-grade fever. His neurological examination revealed normal mental status and cranial nerves, flaccid weakness of both lower extremities and left upper extremity, absent reflexes, flexor plantar responses, and normal sensory examination results. Cerebrospinal fluid examination findings showed 28 cells, predominantly lymphocytes, and normal glucose and protein levels. The patient had no history of polio vaccination, but his 6-month-old daughter was recently vaccinated with an oral polio vaccine. Results from a nerve conduction examination and electromyography were normal. T2-weighted magnetic resonance imaging showed hyperintensities involving bilateral anterior horn cells (Figure 1 and Figure 2).
T2-weighted magnetic resonance image of cervical spine in sagittal plane showing hyperintense signal involving anterior horn cells extending from C3 through C7 (arrow).
T2-weighted magnetic resonance image of cervical spine in axial plane showing hyperintense signal involving anterior horn cells (arrow). Inset, the level of this axial section.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Neurology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.