What is Bulbar Polio?
Bulbar Polio is a form of Paralytic Poliomyelitis in which the brainstem gets attacked by the poliovirus. This attack on the brainstem by the poliovirus results in extensive damage to the motor neurons of the brainstem which control the respiratory system of the body as a result of which a child affected with Bulbar Polio is likely to experience severe breathing difficulties along with dysphagia and dysarthria.
Some children may also complain of difficulty chewing as a result of Bulbar Polio. Due to the respiratory system being involved in Bulbar Polio, it becomes a potentially serious condition which requires emergent treatment. In some cases, artificial ventilation may also be required till the infection runs its course to treat Bulbar Polio.
What Causes Bulbar Polio?
As stated, Bulbar Polio is a type of poliomyelitis and hence is caused by the highly contagious Poliovirus. This virus can infect a child through contact with the feces. Certain objects like toys that may have come in contact with infected feces can transmit the virus to the child. Coming in close contact with an individual who might have been infected may also cause Poliomyelitis with resultant Bulbar Polio through a cough or a sneeze, although this is less common.
Bulbar Polio affects about 1% of the overall people affected with Poliovirus and thus is far less common that other forms of Polio. Poliovirus is usually found in areas which are basically unhygienic and people do not have clean water to drink or clean toilets. In such areas the drinking water gets mixed with contaminated human waste which gives rise to Poliomyelitis which when affects the bulbar region results in Bulbar Polio.
Thus, it is essential for everyone to be vaccinated for Poliomyelitis if they are planning to travel in countries where they have to encounter unhygienic living situations to prevent them from contacting Poliomyelitis which may go onto develop into Bulbar Polio.
What are the Symptoms of Bulbar Polio?
The main characteristics of Bulbar Polio are:
- Problems with breathing
- Dysarthria
- Dysphagia
- Problems with chewing food
In about 10% of cases of Bulbar Polio, the patient may require mechanical ventilation to assist in breathing as the breathing muscles gets severely affected by the viral infection.
How is Bulbar Polio Treated?
As is the case with all forms of Poliomyelitis, Bulbar Polio is also a condition that can be prevented but not cured. The front line approach to treating Bulbar Polio is to treat the symptoms and let the infection run its course. The very first thing that needs to be done for treatment of Bulbar Polio is to quarantine the patient first so that the disease does not spread.
Since the main symptoms of Bulbar Polio is difficulty breathing and dysphagia, the patient may be recommended a liquid diet which may be easy to swallow or in severe cases intravenous fluids may be given to the patient while the patient is kept n.p.o. till the infection clears and the patient is able to swallow again. Ventilatory assistance will be required in severe cases of respiratory difficulty till the time the infection clears and the patient is able to breathe on his or her own accord.
It is important to note here that treatment for respiratory difficulty need to be started at the earliest to prevent any further complications from arising which may put the life of the patient at risk due to respiratory failure. Once the infection is cleared, the patient is then sent to physical therapy for aggressive therapy to strengthen the muscles that assist in breathing including diaphragmatic strengthening exercises as diaphragm gets severely affected as a result of Bulbar Polio.
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