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August 1974

Acute Poliomyelitis Disputed

Author Affiliations

Burlington, Vt

Arch Neurol. 1974;31(2):142. doi:10.1001/archneur.1974.00490380090014

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To the Editor.—  The report, "Acute Poliomyelitis Beginning as Transverse Myelopathy" by Foley and Beresford (Arch Neurol 30:182-183, 1974), may be interpreted differently.The clinical findings strongly suggest a complete transverse myelitis, although it is not certain that a bilateral symmetrical radiculoneuropathy could not have been present at the same time. The cerebrospinal fluid (CSF) findings are nonspecific, even though it is a little unusual to have such an elevated CSF protein level this early in the course of acute poliomyelitis. It is unfortunate that electromyographic studies were not performed, which might have established the existence of anterior horn cell lesions. It is noteworthy that the virus was not isolated from any body fluids.An alternative interpretation of the data might be not acute poliomyelitis, but rather a postinfectious or, perhaps more correctly, a parainfectious transverse myelitis representing an "allergic" reaction to poliovirus type I. Similar reactions have been reported with

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