A 3-year-old child presents with sudden onset of flaccid paralysis of the right lower limb following a febrile illness 2 days ago. Deep tendon reflexes are absent in the affected limb. Sensation is intact. What is the MOST likely diagnosis?

• A Acute flaccid paralysis due to poliovirus ✓
• B Guillain-Barré syndrome
• C Transverse myelitis
• D Hysterical paralysis

Explanation

Acute flaccid paralysis (AFP) with fever, rapid onset (1-2 days), absent reflexes, and preserved sensation in a child is the hallmark of poliomyelitis. Poliovirus destroys anterior horn cells, causing lower motor neuron paralysis. Unlike GBS, sensory function is preserved and involvement is typically asymmetric. All AFP cases in children under 15 years must be reported and stool samples sent for polio surveillance as per WHO protocol.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.