WordNet

drooping without elasticity; wanting in stiffness; "a flaccid penis"
of or relating to a diastole or happening during a diastole

PrepTutorEJDIC

(筋肉などが)たるんだ / (人・性格などが)気力(覇気)のない,柔弱な

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/07 20:43:24」(JST)

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Flaccid paralysis /ˈflæksɪd pəˈræləsɪs/ is a clinical manifestation characterized by weakness or paralysis and reduced muscle tone without other obvious cause (e.g., trauma).^[1] This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit flaccid paralysis. When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation.^[2]

Causes

Polio

The term acute flaccid paralysis (AFP) is often used to describe a sudden onset, as might be found with polio.

AFP is the most common sign of acute polio, and used for surveillance during polio outbreaks. AFP is also associated with a number of other pathogenic agents including enteroviruses, echoviruses, and adenoviruses, among others.^[3]

Botulism

The Clostridium botulinum bacteria are the cause of botulism. Vegetative cells of C. botulinum may be ingested. Introduction of the bacteria may also occur via endospores in a wound. When the bacteria are in vivo, they induce flaccid paralysis. This happens because C. botulinum produces a toxin which blocks the release of acetylcholine. Botulism toxin blocks the exocytosis of presynaptic vesicles containing Acetylcholine (ACh).^[2] When this occurs, the muscles are unable to contract.^[4] Other symptoms associated with infection from this neurotoxin include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Botulism prevents muscle contraction by blocking the release of ACh, thereby halting postsynaptic activity of the neuromuscular junction. If its effects reach the respiratory muscles, then it can cause respiratory failure, leading to death.^[5]

Curare

Curare is a poison that comes from a plant grown in the rainforests of South America. The people of South America crush and cook the roots and stems of curare and then mix it with venom from other plants and animals to create a poisonous syrup mixture that they put on the tips of their arrows. This poison has also been used by South Americans to treat madness, dropsy, edema, fever, kidney stones, and bruises.^[6] Curare acts as a neuromuscular blocking agent which induces flaccid paralysis. This poison binds to the Acetylcholine (ACh) receptors on the muscle, blocking them from binding to ACh. As a result, ACh accumulates within the neuromuscular junction, but since ACh cannot bind to the receptors on the muscle, the muscle cannot be stimulated. This poison must enter the bloodstream for it to work. If curare affects the respiratory muscles, then its effects can become fatal, placing the victim at risk for suffocation.^[2]

Other

Flaccid paralysis can be associated with a lower motor neuron lesion. This is in contrast to an upper motor neuron lesion, which often presents with spasticity, although early on this may present with flaccid paralysis. Included in AFP's list are Poliomyelitis (Polio), Transverse myelitis, Guillain-Barré syndrome, enteroviral encephalopathy,^[7] traumatic neuritis, Reye's syndrome, etc. An AFP Surveillance programme is conducted to increase case yield of poliomyelitis. This includes collection of 2 stool samples within 14 days of onset of paralysis and identification of virus. and control of the outbreak and strengthening immunisation in that area.

Venomous snakes that contain neurotoxic venom such as kraits, mambas, and cobras can also cause complete flaccid paralysis.^{[citation needed]}

References

^ Alberta Government Health and Wellness (2005) Acute Flaccid Paralysis Public Health Notifiable Disease Management Guidelines.
^ ^a ^b ^c Saladin, Kenneth S. Anatomy & Physiology: The Unity of Form and Function. McGraw-Hill. 6th Edition. 2012.
^ Kelly H, Brussen KA, Lawrence A, Elliot E, Pearn J, Thorley B (2006). "Polioviruses and other enteroviruses isolated from faecal samples of patients with acute flaccid paralysis in Australia, 1996-2004". Journal of paediatrics and child health 42 (6): 370–6. doi:10.1111/j.1440-1754.2006.00875.x. PMID 16737480.
^ Disease Listing, Botulism, General Information | CDC Bacterial, Mycotic Diseases
^ "flaccid paralysis - definition of flaccid paralysis in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved 2014-02-26.
^ "Curare - Chondrodendron tomentosum". Blueplanetbiomes.org. Retrieved 2014-02-26.
^ Anis-ur-Rehman, Idris M, Elahi M, Jamshed, Arif A (Jan–Mar 2007). "Guillain Barre syndrome: the leading cause of acute flaccid paralysis in Hazara division". J Ayub Med Coll Abbottabad 19 (1): 26–8. PMID 17867475.

External links

Approach to Acute Flaccid Paralysis (Diagnosis, Management etc.)
WHO Programme for Immunization Preventable Diseases (IPD) A Collaboration between World Health Organization and Government of Nepal
ACUTE FLACCID PARALYSIS information from the IPD
National Polio Surveillance Project of India
"Progress towards poliomyelitis eradication, Nepal, 1996-1999". Wkly. Epidemiol. Rec. 74 (42): 349–53. October 1999. PMID 10895300.
Centers for Disease Control and Prevention (CDC) (September 2002). "Acute flaccid paralysis syndrome associated with West Nile virus infection—Mississippi and Louisiana, July–August 2002". MMWR Morb. Mortal. Wkly. Rep. 51 (37): 825–8. PMID 12353741.
Sejvar JJ, Leis AA, Stokic DS, et al. (July 2003). "Acute Flaccid Paralysis and West Nile Virus Infection". Emerging Infect. Dis. 9 (7): 788–93. doi:10.3201/eid0907.030129. PMC 3023428. PMID 12890318.
Saeed M, Zaidi SZ, Naeem A, et al. (2007). "Epidemiology and clinical findings associated with enteroviral acute flaccid paralysis in Pakistan". BMC Infect. Dis. 7: 6. doi:10.1186/1471-2334-7-6. PMC 1804272. PMID 17300736.

UpToDate Contents

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1. ポリオおよび前角細胞への感染性疾患 polio and infectious diseases of the anterior horn
2. 急性灰白髄炎の世界的根絶 global poliomyelitis eradication
3. 高マグネシウム血症の症状 symptoms of hypermagnesemia
4. ウエストナイルウイルス感染の臨床症状および診断 clinical manifestations and diagnosis of west nile virus infection
5. 重症疾患に関連する神経筋脱力 neuromuscular weakness related to critical illness

English Journal

Upsurge of Enterovirus D68, the Netherlands, 2016.

Knoester M, Schölvinck EH, Poelman R, Smit S, Vermont CL, Niesters HG, Van Leer-Buter CC.
Emerging infectious diseases.Emerg Infect Dis.2017 Jan 15;23(1). doi: 10.3201/eid2301.161313. [Epub ahead of print]
In June and July 2016, we identified 8 adults and 17 children with respiratory enterovirus D68 infections. Thirteen children required intensive care unit admission because of respiratory insufficiency, and 1 had concomitant acute flaccid myelitis. Phylogenetic analysis showed that all of 20 sequence
PMID 27660916

Semen quality impairment is associated with sexual dysfunction according to its severity.

Lotti F1, Corona G1,2, Castellini G1, Maseroli E1, Fino MG1, Cozzolino M3, Maggi M4,5.
Human reproduction (Oxford, England).Hum Reprod.2016 Dec;31(12):2668-2680. Epub 2016 Oct 12.
STUDY QUESTION: Is sexual dysfunction associated with severity of semen quality impairment in men with couple infertility SUMMARY ANSWER: In males of infertile couples the prevalence of erectile dysfunction (ED) increases as a function of semen quality impairment severity.WHAT IS KNOWN ALREADY: Infe
PMID 27733531

Measuring polio immunity to plan immunization activities.

Voorman A1, Lyons HM2.
Vaccine.Vaccine.2016 Nov 21;34(48):5946-5952. doi: 10.1016/j.vaccine.2016.10.017. Epub 2016 Oct 19.
The Global Polio Eradication Initiative is closer than ever to achieving a polio-free world. Immunization activities must still be carried out in non-endemic countries to maintain population immunity at levels which will stop poliovirus from spreading if it is re-introduced from still-infected areas
PMID 27771181

Guillain-Barré syndrome: a century of progress.

Goodfellow JA1, Willison HJ2.
Nature reviews. Neurology.Nat Rev Neurol.2016 Nov 18. doi: 10.1038/nrneurol.2016.172. [Epub ahead of print]
In 1916, Guillain, Barré and Strohl reported on two cases of acute flaccid paralysis with high cerebrospinal fluid protein levels and normal cell counts - novel findings that identified the disease we now know as Guillain-Barré syndrome (GBS). 100 years on, we have made great progress with the cli
PMID 27857121