Nonparalytic Polio and Postpolio Syndrome

National Rehabilitation Hospital, Washington, DC 20010, USA.
American Journal of Physical Medicine & Rehabilitation (Impact Factor: 2.2). 01/2000; 79(1):13-8. DOI: 10.1097/00002060-200001000-00005
Source: PubMed


We describe four cases of postpolio syndrome with typical histories, physical examination results, and electrodiagnostic evidence of extensive anterior horn cell disease, as well as the putative pathophysiology of postpolio syndrome in persons with histories of nonparalytic polio and the diagnostic implications for individuals older than 40 yr of age who are experiencing unexplained new weakness, fatigue, and muscle or joint pain. Although the diagnosis of postpolio syndrome traditionally has required a remote history of paralytic polio, many persons such as the ones described here with typical symptoms of postpolio syndrome have no clear history of paralytic disease and are being misdiagnosed. With this in mind, we believe that the diagnostic criteria for postpolio syndrome should be modified to include the following: a history of remote paralytic polio or findings on history, physical examination results, and laboratory studies compatible with poliovirus damage of the central nervous system earlier in life.

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    ABSTRACT: Resumé Årtier efter den akutte polio, udvikler mange poliooverlevere ny muskelsvaghed og andre symptomer, der kan føre til øget svaghed. Behandlingen skal målrettes de mest fremtraedende symptomer. Medicin kan hjaelpe, såvel som fysioterapi og et moderat tilpasset motionsprogram. Screening af knogletaethed og for osteoporose anbefales. Hovedpunkter PPS rammer anslået 60% af de der havde "paralytisk" polio, og et ukendt antal af de, der havde polio uden lammelser. PPS er en udelukkelsesdiagnose. Symptomer er relateret til ny muskelsvaghed og kan omfatte muskelatrofi, smerter i musklerne, traethed og problemer med at synke og at traekke vejret. Der er ingen medicin, der virker specifikt på PPS. Pyridostigmin har blandet men ikke signifikant virkning mod svaghed og traethed. Det samme er gaeldende for methylphenidat og bromocriptin. Modafinil kan virke mod traethed. Nonsteroide antiinflammatoriske laegemidler (NSAID/ gigtmidler) anvendes til behandling af smerter. Rehabiliteringsfagfolk, der har ekspertise inden for behandling af PPS kan med viden og behandling vaere til vaerdifuld hjaelp for, at PPS ramte kan bevare funktionen og forebygge yderligere svaekkelse. Når en poliooverlever kommer med nye uspecifikke symptomer som svaghed og traethed, hvordan afgør man så, om det er relateret til PPS eller skyldes andre årsager end polio? PPS er en neurologisk lidelse defineret som en samling af symptomer opstået årtier efter den akutte polioinfektion og en mellemliggende stabil periode. Ny muskelsvaekkelse er ofte hovedproblemet, men vejrtraekningsproblemer, synkebesvaer, traethed, muskelsmerter og kuldeintolerance er oftest også repraesenteret. I denne gennemgang diskuterer vi kriterierne for diagnosticering af PPS, retningslinier for at udelukke andre forhold, der kan gøre sig gaeldende, og behandlingsstrategier for at optimere den fysiske formåen hos PPS ramte.
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    ABSTRACT: ABSTRACTA condition called “Post-polio Syndrome” (PPS) is a special type of neuromuscular disturbance that affects some elderly patients who had polio myelitis either as children or as young adults. It has been reported that approximately 1,600,000 polio survivors are alive today. Most will seek dental care, and up to half of the survivors will present with some form of PPS. This paper describes polio, its characteristics, and the long-term consideration of PPS, and discusses the special clinical implications related to this condition. Special emphasis is placed on physical impairments, breathing problems, and difficulty swallowing. Also included are sections discussing such topics as patient scheduling, office design and housekeeping, patient management, oral hygiene, diagnostic procedures, drug and pain management, and general health considerations.
    Special Care in Dentistry 08/2001; 21(5):167 - 171. DOI:10.1111/j.1754-4505.2001.tb00249.x
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    ABSTRACT: A study of the clinical features, physical activity, muscle enzyme, electromyography and histopathological alternations of muscles in patients with post-polio syndrome (PPS). To assess the varied patterns of PPS in Taiwan. Taiwan. Thirty-one patients who fulfill the inclusion criteria of PPS were selected for study. Clinical features, physical activity scale, serum concentrations of creatine kinase, electromyography and histopathological alterations of muscles were assessed and correlated to the causes of PPS patients. Patients with PPS in Taiwan are relatively young, with a mean age of 39.3 years. Elevated concentration of creatine kinase was found predominantly in male patients with higher physical activities. Electromyographic examinations as well as histological tests of affected muscles revealed prominent evidence of chronic and active denervation with reinnervation in PPS patients. Patients with PPS in Taiwan are young. Thus, PPS should not be attributed to aging. Physical attrition with degradation of nerve terminals is considered the main cause of this disease. This study was supported by the National Science Council, Republic of China under grant no. NSC-83-0412-B002-302.
    Spinal Cord 11/2001; 39(10):526-31. DOI:10.1038/ · 1.80 Impact Factor
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