Acute Ascending Paralysis.
Definition.—An acute paralysis beginning in the lower extremities, and extending rapidly upward to the trunk and to the upper extremities, neck, and face, and finally involving the medulla. Its course is rapid and generally terminates fatally.
Etiology.—The disease occurs more often in men than in women, and between the ages of twenty and thirty. The disease is of unknown origin, and while it has followed cold, malaria, syphilis, and other infectious diseases, it is more likely a coincidence than a result.
Pathology.—There are no characteristic pathological changes found. In some cases an interstitial neuritis has been found, while in others the lesion has been that of myelitis. While the microscope fails to reveal any morbid changes in many cases, in others there is softening and extravasation of blood into the gray substance.
Symptoms.—The first evidence of the disease is a sense of weakness in the lower extremities which soon develops into paralysis. Beginning in the toes, it rapidly extends up the legs and thighs to the muscles of the trunk, arms, and neck, involving respiration, deglutition, and articulation. The muscles do not waste, electrical reactions are maintained, though the reflexes are lost.
The bladder and rectum are not involved, and bed-sores are rarely developed. There may be paresthesia, though sensory symptoms are not constant. The disease may terminate fatally in forty-eight hours, or be postponed for one or two weeks.
Diagnosis.—Weakness of the limbs, rapidly followed by paralysis, beginning in the feet and rapidly ascending to the trunk, neck, and face; impaired respiration, relaxation of muscles, with but little atrophy; loss of the reflexes; absence of electric changes, and absence of sensory symptoms, make the diagnosis comparatively easy.
Prognosis.—Recovery occurs only in rare cases.
Treatment.—The treatment will be symptomatic, and similar to that for any acute disease of the cord.
When following an infectious disease, the antiseptics might be given with benefit, notably echinacea.
After the acute symptoms subside, electricity and massage should be tried.