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Case Report
From the diagnosis of a probable post-polio syndrome to spina bifida: A case report of a 49-year-old man
1 Master’s Program in Neurology - University of Vassouras and School of Medicine - University Iguaçu - RJ, Brazil
2 Iguaçu University - UNIG - Department of Neurology of Hospital Geral de Nova Iguaçu - RJ, Brazil
3 Department of Neurology of Federal University of Rio de Janeiro - UFRJ, RJ, Brazil
4 Department of Neurology and Neurosurgery - UNIFESP, Paulista School of Medicine, São Paulo, SP, Brazil
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Antônio Marcos da Silva Catharino
Rua Gavião Peixoto 70, Room 811, CEP 24.2230-100, Icaraí, Niterói-RJ,
Brazil
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Article ID: 101335Z01MO2022
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Orsini M, da Silva Catharino AM, Silveira VC, Reis CHM, de Freitas MRG, de Rezende Pinto WBV, Oliveira ASB. From the diagnosis of a probable post-polio syndrome to spina bifida: A case report of a 49-year-old man. Int J Case Rep Images 2022;13(2):98–101.ABSTRACT
Introduction: Post-polio syndrome is defined as a specific clinical condition that affects individuals previously affected by acute anterior poliomyelitis and, undoubtedly, is an exclusion diagnosis. Among the range of differential diagnoses, spina bifida may be one of them. Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD) and can happen anywhere along the spine if the neural tube does not close all the way. When the neural tube doesn’t close all the way, the backbone that protects the spinal cord doesn’t form and close as it should. This often results in damage to the spinal cord and peripheral nerves.
Case Report: We report the case of a patient, male, 49 years old, with an alleged diagnosis of post-poliomyelitis syndrome (PPS) for benefit renewal due to permanent and disabling motor disability. After a thorough clinical history and neurological evaluation, in addition to the characteristic findings of spina bifida: bilateral pes cavus, fecal and urinary incontinence, surgical incision in the lumbar region, genu varus, amyotrophyparesis in lower limbs and abolition of bilateral Achilles reflexes, spina bifida diagnoses was considered.
Conclusion: This article presents some “clinical pearls” in the differential diagnoses of spinal cord diseases. The possibility of PPS was excluded and the application for the benefit for spina bifida was redone. In addition to the post-history diagnoses determined by the diagnosis of diagnostic syndrome (that were not scored by our patient), the sum of the clinical history, the neurological examination and anchored spine in the image by revisions, were the foundation for the diagnosis of the bifida spina.
Keywords: Differential diagnosis, Post-polio syndrome, Rare diseases, Spina bifida, Spinal cord
SUPPORTING INFORMATION
Author Contributions
Marco Orsini - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Antônio Marcos da Silva Catharino - Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Valéria Camargo Silveira - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Carlos Henrique Melo Reis - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marcos RG de Freitas - Conception of the work, Design of the work, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Wladimir Bocca Vieira de Rezende Pinto - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Acary Souza Bulle Oliveira - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Marco Orsini et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
