Evaluation of the patient with acute flaccid paralysis

History and examination

MRI of the spine

MRI of the brain if bulbar involvement

Cerebrospinal fluid analysis

Cell count and differential

Protein

Glucose

Oligoclonal bands

IgG index

Viral PCRs (nonpolio enteroviruses, flaviviruses)

Flavivirus antibody testing (West Nile virus, Zika virus)

Blood testing

Anti-AQP4 antibody

Anti-MOG antibody

Sedimentation rate

Autoimmune serology for vasculitis

Lyme titers

HIV PCR and serology

HTLV-1 titers

CK level

West Nile virus IgM antibody

Zika and dengue serology if indicated

Stool samples for polio and nonpolio enteroviruses

Nasopharyngeal swabs for nonpolio enteroviruses

Respiratory tract culture and toxin testing for diphtheria

Toxin testing in serum, stool, and wounds for botulism

Urinary porphobilinogen for porphyria

Acetylcholine receptor antibodies for myasthenia gravis

Electrodiagnostic testing (electromyography, nerve conduction studies, and repetitive stimulation studies)

Nerve and muscle biopsy if vasculitis suspected

MRI: magnetic resonance imaging; IgG: immunoglobulin G; PCR: polymerase chain reaction; AQP4: aquaporin 4; MOG: myelin oligodendrocyte glycoprotein; HTLV-1: human T-cell lymphotropic virus type 1; CK: creatine kinase; IgM: immunoglobulin M.

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خرید پکیج

Evaluation of the patient with acute flaccid paralysis