Traumatic Injection Neuropathy in children presenting with acute flaccid paralysis at a tertiary care hospital of Peshawar

Abstract

Introduction: Acute Flaccid Paralysis (AFP) is the acute onset of focal weakness or flaccid paralysis without obvious cause, such as trauma, in children less than 15 years old. Pakistan is endemic for polio and any case of AFP raises alarms regarding polio infection. High and variable rates of traumatic injection neuropathy are reported in the literature among children who present with AFP, a finding that is applicable to our settings.
Objective: To determine the magnitude of traumatic injection neuropathy among children presenting with acute flaccid paralysis at a tertiary care hospital of Peshawar.
Materials & Methods: This cross sectional study was carried out at Pediatric Department, Hayatabad Medical Complex, Peshawar from January 27, 2020 to July 27, 2020, during which time 193 patients of Acute Flaccid Paralysis were observed after getting informed consent. A detailed history was obtained and clinical examination conducted to identify the cause of AFP. Data were recorded on a designed Performa and analyzed in SPSS 22 for descriptive statistics.
Results: Of 193 children, 72% children were in age range 1-7 years while 28% were in age range 8-15 years; 110(57%) children were male and 83(43%) children were female. Moreover 17(9%) children had Traumatic Injection Neuropathy (TIN), of whom 13(76.5%) were from the rural areas.
Conclusion: Despite misgivings, the magnitude of Traumatic Injection Neuropathy in children with Acute Flaccid Paralysis was within the figures reported by international literature; however, there should be concerted attempts to decrease this figure further, particularly in the rural areas.