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

    The doctor will ask 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. Other, less common tests may include:
  • Treatment

    Treatment focuses on managing symptoms. The goals 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
    • Immunoglobulin—currently being studied to treat PPS
  • 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.com

    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.

    The Post-polio program. National Rehabilitation Hospital website. Available at: http://www.nrhrehab.org/Patient+Care/Programs+and+Service+Offerings/Outpatient+Services/Service%5FPage.aspx?id=39.

    Post-polio syndrome. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/post-polio-syndrome/DS00494/DSECTION=symptoms. Updated March 2, 2008. Accessed February 9, 2009.

    Rowland LP, ed. Merritt's Neurology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.

    Revision Information

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