Sometimes a patient presents with residual effects of a remote episode of flaccid paralysis. Several features are seen in patients with a history of poliomyelitis.
Clinical features suggesting past poliomyelitis:
(1) presence of fever and myalgias when the acute flaccid paralysis occurs (progression of paralysis stops when the patient becomes afebrile)
(2) flaccid paralysis with asymmetrical muscle involvement
(3) tendency to involve more proximal muscles in an extremity
(4) tendency to affect larger muscle groups in the hand or foot more than smaller muscle groups
(5) absence of sensory loss with rare exceptions
(6) presence of muscle atrophy with or without skeletal deformities
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