Poliomyelitis

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  • i. Lytic infection of motor neurons with destruction predominantly in the spinal cord but may also involve neurons within the brain (polioencephalomyelitis)
  • ii. Small RNA enterovirus spread hematogenously
    • 1. a type of picornavirus; other viruses in this family = coxsackie and echovirus
  • iii. Spinal gray matter is usually involved, particularly the anterior horn cells but virus also has predilection for motor nuclei in the pons and medulla, reticular formation and deep cerebellar nuclei
  • iv. Microscopically: inflammation in the leptomeninges and affected gray matter; histologic hallmark of viral infection of neurons is neuronophagia (aggregation of microglia and macrophages around dead neurons) – clusters of microglia mark the sites of destroyed neurons for several weeks after their resorption; there is often congestion of small blood vessls in the areas of inflammation that may be associated with perivascular hemorrhage and focal necrosis
    • 1. gitter cells are microglia cells that are transformed into fatty macrophages 48 hours after brain tissue damage
  • v. poliomyelitis may have both fasciculation and fibrillation potentials
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