Which neurologic findings are characteristic of diphtherial Corynebacterium infections?

Updated: Jun 14, 2019
  • Author: Lynda A Frassetto, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Signs of cranial nerve dysfunction can occur within a few days of disease onset, with paralysis of the soft palate and posterior pharyngeal wall causing dysphagia and regurgitation.

Although the motor component is usually affected most severely, both sensory and motor nerves are affected by the peripheral neuritis that occurs later.

The symptoms start in the proximal muscle groups of the extremities and spread distally.

In mild cases, only the hip girdle muscles may be affected; these patients have trouble getting out of a chair unassisted. In these patients, the motor reflexes of the lower extremities may be normal.

In the most extreme cases, respiratory muscle dysfunction occurs and patients may require respiratory support.

Interestingly, reports show that the paralysis disappears at the same rate that it appears.

Even in extremely serious cases, the neuropathy is reversible with few or no sequelae.

In severe cases, the paralysis can spread to the trunk and cause temporary bowel and bladder dysfunction.

Paresthesias, which mainly occur distally, are the most commonly reported sensory abnormalities.


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