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 the original polio virus. However, the virus can cause damage to nerve and muscle cells that may lead to the development of PPS.

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:

• MRI scan
• Muscle biopsy
• Spinal tap

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 may have a reduced risk of PPS.