Etiology and Outcomes of Acute Flaccid Paralysis in Adults: A Study in Tertiary Care Center.

Abstract

INTRODUCTION: The World Health Organization defines acute flaccid paralysis syndrome as rapid onset of weakness of an individual's extremities, often including weakness of the muscles of respiration and swallowing, progressing to maximum severity within 1 to 10 days. We carried out this observational study in a tertiary care center in North India with the aim of determining the etiology and outcome of Acute Flaccid Paralysis in adults. METHODS: In this observational study, all cases diagnosed with Acute flaccid paralysis admitted to the tertiary care center from 1st January 2015 till 30th June 2016 were enrolled. Ninety-seven consecutive patients of age above 18 years presenting with weakness of duration less than two weeks were enrolled after obtaining informed consent and various investigations were studied. RESULTS: The study analyzed data of 97 patients presenting with flaccid paralysis. They were analyzed for the demographic data, clinical features, investigations, electrophysiological data, and results of the treatment. The most common etiology of acute flaccid paralysis in this entire population was GBS, which was responsible for 50.5% of the cases, followed by the Hypokalemic paralysis (25.8%) followed by neuroparalytic snake bite (15.5%).In this study, 48% of patients with hypokalemic paralysis had a secondary cause for their condition. Primary hypokalemic periodic paralysis occurred in 52% of patients. CONCLUSIONS: In this observational study, GBS was found to be the most common cause for Acute Flaccid Paralysis followed by Neuroparalytic snake bite. Respiratory paralysis was an important risk factor associated with mortality.