Difference Between Poliomyelitis & Guillain-Barre syndrome

Difference Between Poliomyelitis & Guillain-Barre syndrome

Poliomyelitis and Guillain-Barré Syndrome (GBS) are both neurological conditions affecting motor function but differ significantly in cause, pathology, and treatment. Here’s a detailed comparison:

1. Cause:

• Poliomyelitis:
  Caused by the poliovirus, which primarily spreads through the fecal-oral route. It targets the anterior horn cells of the spinal cord, leading to motor neuron destruction.
• Guillain-Barré Syndrome (GBS):
  An autoimmune disorder often triggered by infections (e.g., Campylobacter jejuni, Epstein-Barr virus) or vaccinations. The immune system attacks peripheral nerves, leading to demyelination or axonal damage.

2. Pathophysiology:

• Poliomyelitis:
  The virus invades and destroys motor neurons in the spinal cord and brainstem, resulting in muscle paralysis. The damage is permanent in severe cases.
• GBS:
  Involves an immune-mediated attack on the myelin sheath or axons of peripheral nerves. It often starts with inflammation and progresses to muscle weakness or paralysis. Unlike polio, the damage is typically reversible with treatment.

3. Onset:

• Poliomyelitis:
  Gradual onset following a viral infection. Symptoms may start with fever, headache, and fatigue, progressing to paralysis over a few days.
• GBS:
  Sudden onset, often preceded by respiratory or gastrointestinal infection. Symptoms progress rapidly, peaking within days to weeks.

4. Symptoms:

• Poliomyelitis:
  • Asymptomatic in most cases (90-95%).
  • Paralytic polio causes asymmetric flaccid paralysis, usually affecting the lower limbs.
  • Reflexes are diminished or absent, but sensation remains intact.
• GBS:
  • Symmetrical ascending weakness (starts in the legs and progresses upward).
  • Tingling or numbness in extremities.
  • Reflexes are diminished or absent.
  • May involve respiratory muscles, leading to respiratory failure in severe cases.

5. Diagnosis:

• Poliomyelitis:
  Diagnosed via stool, throat swabs, or cerebrospinal fluid (CSF) testing for poliovirus RNA.
• GBS:
  Diagnosed through clinical symptoms, nerve conduction studies, and CSF analysis showing elevated protein levels with normal white cell count (albuminocytologic dissociation).

6. Treatment:

• Poliomyelitis:
  No specific antiviral treatment. Management focuses on supportive care, including physical therapy to reduce contractures and improve mobility. Prevention via the polio vaccine is key.
• GBS:
  Treated with intravenous immunoglobulin (IVIG) or plasmapheresis to reduce immune-mediated damage. Supportive care includes ventilation in severe cases and physical rehabilitation for recovery.

7. Prognosis:

• Poliomyelitis:
  Permanent paralysis in severe cases; recovery depends on the extent of neuron destruction. Post-polio syndrome may occur years later.
• GBS:
  Most patients recover fully within months to a year. Residual weakness may persist in some cases.

8. Prevention:

• Poliomyelitis:
  Vaccination (oral or inactivated polio vaccine).
• GBS:
  No vaccine; prevention focuses on managing infections and reducing immune triggers.

Summary:

• Poliomyelitis is a viral disease with asymmetric, irreversible paralysis.
• GBS is an autoimmune disorder with symmetric, potentially reversible weakness.

Proper diagnosis and treatment are critical for both conditions to minimize complications.