One-tenth of 1 percent, however, suddenly develop severe headaches, fever, muscle pains, and neck stiffness, suggestive of meningitis. There is a tingling sensation in the limbs, increased weakness, and paralysis. Bulbar and respiratory poliomyelitis may be fatal. Many patients suffering from paralysis during the illness regain most, or all, movement in time, but in severe cases paralysis may remain. Some residual paralysis does remain in one-third of all survivors.
Mild cases require bed rest.
Severe cases need isolation and complete bed rest, with slight sedation and painkilling drugs. With respiratory paralysis, artificial respirators and a tracheostomy are necessary. A physiotherapist regularly moves the patient's joints to prevent stiffness. Extra fluids are given to prevent dehydration. The patient may have to be fed through a tube into the stomach, and a catheter is needed if the bladder is paralyzed.