During the latter half of August, 1924, a small outbreak of acute anterior poliomyelitis occurred in Winnipeg. The most interesting feature of this outbreak was the constant occurrence of acute bulbar paralysis with complete absence of limb involvement.
The occurrence of transient bulbar paralysis and its association with spinal symptoms and paralysis have frequently been noted. A constant localization of the virus in the medulla and pons with no clinical signs elsewhere is unusual and merits notice.
Medin,1 in 1890, drew attention to the rarity of cranial nerve involvement without signs of limb paralysis. Peabody,2 in 1911, described only four examples of true bulbar paralysis in a series of 183 carefully studied cases. In a series of 868 cases seen by Wickman3 in 1905, only thirty-four showed cranial nerve involvement alone, and in these the facial nerve was most commonly affected. The ninth, tenth or eleventh nerves