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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.

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