Post-polio Syndrome
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Post-polio Syndrome

En Español (Spanish Version)

Definition

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

Causes

The exact cause of PPS is unknown. It is not due to renewed progression of the original polio infection. However, long-term damage to nerve and muscle cells caused by the polio infection may contribute to the development of PPS.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The only absolute risk factor for PPS is a previous polio attack. However, both a younger age at initial polio infection and more severe disease seem to predict those who are at greater risk for developing PPS.

Risk factors include:

  • Previous polio attack
  • Severity of original polio attack
  • Age at onset (worse for those who acquire polio later in life)

Symptoms

Symptoms may include:

  • Fatigue
  • Slowly progressive muscle weakness
  • Muscular atrophy
  • Muscle spasms
  • Joint pain
  • Muscle pain
  • Difficulty swallowing, breathing, or sleeping
  • Intolerance to heat or cold
  • Speech problems
  • Skeletal deformities, such as scoliosis

Scoliosis

Scoliosis

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The severity of the initial polio attack may indicate how severe the symptoms of PPS will be.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a neuromuscular exam. PPS may be hard to diagnose because symptoms come and go, and overlap with other diseases.

Testing often involves electromyography. This measures electrical activity in affected muscles. Other, less common tests may include:

  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the body
  • Muscle biopsy—removal of a sample of muscle tissue for testing
  • Spinal tap—insertion of a needle between the vertebrae in the lower back to remove cerebrospinal fluid for testing

Treatment

Treatment focuses on managing symptoms. The goals of treatment are to:

  • Prevent overuse of weak muscles
  • Prevent disuse atrophy and weakness
  • Protect joints left vulnerable 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

Prevention

There are no guidelines for preventing PPS. However, polio survivors who keep physically fit are probably at reduced risk.

RESOURCES:

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

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

CANADIAN RESOURCES:

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

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

References:

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

Merritt's Neurology . 11th ed. Lippincott Williams & Wilkins; 2005.

The Post-polio Program. National Rehabilitation Hospital website.
Available at: http://www.nrhrehab.org/Patient+Care/Programs+and+Service+Offerings/ Outpatient+Services/Service_Page.aspx?id=39.



Last reviewed February 2008 by David L. Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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