Post-polio Syndrome

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Post-polio Syndrome

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 may occur 10 to 40 years after the initial polio attack.

Causes

The exact cause 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 may contribute to the development of PPS.

Risk Factors

These factors increase your chance of developing PPS. Tell your doctor if you have any of these risk factors:

Previous polio attack—the only absolute risk factor
Severity of original polio attack
Age at onset (worse for those who get 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 (eg, scoliosis )

Scoliosis

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. She will also do a neuromuscular exam. PPS may be hard to diagnose because symptoms come and go. The symptoms also 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 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
Medicine 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 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%5Fe.html/

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

Reviewer: Rosalyn Carson-DeWitt, MD
Review Date: 12/2011 -
Update Date: 12/30/2011 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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