From the diagnosis of a probable post-polio syndrome to spina bifida: A case report of a 49-year-old man

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.