WordNet

drooping without elasticity; wanting in stiffness; "a flaccid penis"
loss of the ability to move a body part (同)palsy

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
(体の)麻痺(まひ),中風 / (…の)停滞《+『of』+『名』》

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/06 20:10:23」(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 spastic paralysis, 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.

Look up flaccid in Wiktionary, the free dictionary.

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1. 救急外来における急性の筋力低下を訴える成人の評価 evaluation of the adult with acute weakness in the emergency department
2. 筋力低下を呈する小児の病因および評価 etiology and evaluation of the child with muscle weakness
3. 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
4. 小児におけるギラン・バレー症候群の概要 overview of guillain barre syndrome in children
5. 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

English Journal

Current thoughts and developments in facial nerve reanimation.

Faris C, Lindsay R.SourceaDepartment of Otolaryngology/Head and Neck Surgery, Queens Medical Centre, Nottingham University Hospitals, Nottingham, UK bDepartment of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
Current opinion in otolaryngology & head and neck surgery.Curr Opin Otolaryngol Head Neck Surg.2013 Aug;21(4):346-52. doi: 10.1097/MOO.0b013e328362a56e.
PURPOSE OF REVIEW: To present the most current literature regarding the management of acute and chronic facial paralysis. This review will focus primarily on smile reanimation in the setting of acute and chronic facial paralysis. The management of the flaccid and the hypertonic face will be discusse
PMID 23756337

West Nile virus: review of the literature.

Petersen LR, Brault AC, Nasci RS.SourceDivision of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, US Public Health Service, Department of Health and Human Services, Fort Collins, Colorado 80521, USA. lxp2@cdc.gov
JAMA : the journal of the American Medical Association.JAMA.2013 Jul 17;310(3):308-15. doi: 10.1001/jama.2013.8042.
IMPORTANCE: Since its introduction in North America in 1999, West Nile virus has produced the 3 largest arboviral neuroinvasive disease outbreaks ever recorded in the United States.OBJECTIVE: To review the ecology, virology, epidemiology, clinical characteristics, diagnosis, prevention, and control
PMID 23860989

Neuroinvasive west nile virus disease in Canada. The Saskatchewan experience.

Téllez-Zenteno JF, Hunter G, Hernández-Ronquillo L, Haghir E.SourceDivision of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques.Can J Neurol Sci.2013 Jul;40(4):580-4.
Background: West Nile virus (WNV) is a virus of the family Flaviviridae. The main route of human infection is through the bite of an infected mosquito. Approximately 90% of WNV infections in humans are asymptomatic, but neurologic manifestations can be severe. Methods: This study reviews the clinica
PMID 23786744