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To diagnose poliomyelitis it is necessary to know the types of poliomyelitis that have been described. These are noted in table 1.
Rarely is the clinical disease solely abortive, peripheral, meningeal, cortical, facial or hemiplegic. Usually the patient has a combination of types with spinal or bulbar involvement. Thus, a patient may have a bulbospinal or spinal condition with one or more of the following: meningeal irritation, some form of peripheral nerve irritation, a facial involvement, hemiplegic involvement and, in rare instances, a cortical reaction. Uncomplicated disease of the spinal cord is not fatal unless there is Landry's type of spread of the disease or the infection spreads to and involves the cervical area. Incidentally, the mortality rate is highest in the group of cases of bulbar and bulbospinal poliomyelitis.
Poliomyelitis is a disease of the lower motor neurons. In the fully developed case, the deep reflexes are decreased or
TOOMEY JA. DIAGNOSIS OF POLIOMYELITIS. JAMA. 1941;117(4):269–273. doi:10.1001/jama.1941.72820300017006a