Causes and Differential Diagnosis of Acute Flaccid Paralysis

Infectious  
Viral  
Enteroviruses Poliomyelitis, Coxsackie A ( A7, A9; A4, A5, A10), Coxsackie B (B1-B5), echoviruses (6,9; 1-4, 7, 11, 14, 16-18, 30), enterovirus 70 enterovirus 71
Other Viruses Myxoviruses (mumps virus), toga and arborviruses, Epstein-Barr Virus; human immunodeficiency virus (HIV), Japanese B encephalitis virus, West Nile virus
Bacterial Campylobacter jejuni (leading cause of Guillain-Barre syndrome)
Metabolic- transient and periodic paralysis
Hypokalemic Familial, Sjogren’s Syndrome, hyperthyroidism, gossypol induced (toxic phenolic pigment in the cottonseed), association with barium poisoning, association with hyperaldosteronism
Normo- or hyperkalemic Hypophosphatemia Familial, adynamia episodia hereditaria of Gamstorp
Drug Induced  
Heroin  
Antibiotics Aminoglycosides, polymyxin B, tetrayclines
Organic  
Volatile hydrocarbons Hexane, methyl butyl ketone, carbon disulfide
Trecresyl phosphate Jamaican ginger tonic; contaminant of cooking oil, mustard oil, or flour
Other Cantharidin, diethyltoluamide (DEET), dithiobiuret (rat poison), triethyldodecyl-ammonium bromide (mouse poison)
Toxins  
Bacterial Botulinum, diphtheria, tetanus (cephalic form), moraxella
Fungal-mycotoxins Penicillium citrea-viridae, Penicillium islandicum, Penicillium citrinum
Insect Tick paralysis; spider venom; cockroach, beetle; wasp venom; Lepidoptera larvae
Parasite/protozoa/dinoflagellates Paralytic shellfish poisoning-saxitoxin, ichthyotoxism (sardines)
Reptiles-snake venom Cobra, Australian elapid, krait, mamba, Sea snake
Plants and plant toxin Gloriosa superba (daisy) [root], Lathyrus species (sweet pea), Aconitum (monkhood), hemlock (parsley), Karwinskia humboldtiana/coyotillo (buckthorn) [berries], Calliopsis species (daisy), Cassia (bean), Cycas (evergreen), [seeds], Gelsemium [blossoms], Heliotropium (bush tea shrub), Melochia species [stems], Oenanthe species 9parsnips0
Metals Organic tin compounds, lead
Pesticides EPN, trichlorfon (Dipterex, dichlorvos (DDVP), DEF, isofenphos (Oftanol), leptophos (Phosel)
Inherited/congenital/acquired Werdnig-Hoffmann disease, Wohlfart-Kugelberg-Welander disease, porphyric polyneuropathy
Unknown/multiple causes Guillain-Barre syndrome, China paralytic syndrome, Bell’s palsy, transverse myelitis
Asthma Polio-like Hopkins’ syndrome
   
   

Source: Plotkin, S., Orenstein, W.;Vaccines, 4th edition. p. 657, Table 25-2.; 2004.