Post-polio Syndrome

Definition

Post-polio syndrome (PPS) is a condition that affects polio survivors. About 20%-40% of people who recover from polio will later develop PPS. The onset may occur 10-40 years after the initial polio attack.

Causes

The exact cause is unknown. It is not due to the original polio virus itself. Instead, the syndrome is due to nerve and muscle damage that may have been caused by the original infection.

Risk Factors

Factors that may increase your chance of developing PPS include:
  • Previous polio attack
  • Severe original polio attack
  • Later age at onset of infection

Symptoms

Symptoms may include:
  • Slowly progressive muscle weakness
  • Muscular atrophy
  • Muscle spasms
  • Muscle pain
  • Difficulty swallowing or breathing
  • Intolerance to heat or cold
If the symptoms during the first attack of polio were severe, the symptoms of PPS may also be severe.

Diagnosis

You will be asked about your symptoms and medical history. A neuromuscular exam may also be done. PPS may be hard to diagnose because symptoms come and go. The symptoms may also overlap with other diseases.Testing often involves electromyography. This measures how well your nerves and muscles are communicating. Images may be taken of your bodily structures. This can be done with an MRI scan. Your bodily fluids may be tested. This can be done with:

Treatment

Treatment focuses on managing symptoms. The goals are to:
  • Prevent overuse of weak muscles
  • Prevent disuse, atrophy, and weakness
  • Protect joints from weak muscles
  • Maximize function
  • Minimize discomfort
Treatment may include:
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Assistive devices
  • Weight loss, if overweight
  • Medication to relieve muscle spasms and pain
  • Occasionally, surgery to correct deformities that interfere with function
  • Immunoglobulin—currently being studied to treat PPS

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Prevention

There are no guidelines for preventing PPS. But polio survivors who keep physically fit may have a reduced risk of PPS.

RESOURCES

March of Dimes
http://www.marchofdimes.org

Post-Polio Health International
http://www.post-polio.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Health Canada
http://www.hc-sc.gc.ca

References

Dalakas M. IVIg in other autoimmune neurological disorders: current status and future prospects. Journal of Neurology. 2008;255(Suppl 3):12-16.

Howard R. Poliomyelitis and the postpolio syndrome. BMJ. 2005;330:1314-1318.

Post-polio syndrome fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/post%5Fpolio/detail%5Fpost%5Fpolio.htm. Updated April 16, 2014. Accessed September 5, 2014.

What is post-polio syndrome? Post-Polio Health International website. Available at: http://www.post-polio.org/edu/pps.html. Accessed September 5, 2014.

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