This syndrome causes a number of potentially serious symptoms that appear decades after the polio virus.
Post-polio syndrome refers to a cluster of potentially disabling signs and symptoms that appear decades — an average of 30 to 40 years — after the initial polio illness.
Polio once resulted in paralysis and death. However, the inactivated polio vaccine greatly reduced polio's spread.
Today, few people in developed countries get paralytic polio, thanks to the vaccine introduced in 1955. However, people who had polio at a young age might get post-polio syndrome.
Common signs and symptoms of post-polio syndrome include:
In most people, post-polio syndrome tends to progress slowly, with new signs and symptoms followed by periods of stability.
If you have increasing weakness or fatigue, see your doctor. It's important to rule out other causes of your signs and symptoms and determine whether you have post-polio syndrome.
There are several theories as to what causes post-polio syndrome, but no one knows for sure.
When poliovirus infects your body, it affects nerve cells called motor neurons — particularly those in your spinal cord — that carry messages (electrical impulses) between your brain and your muscles.
Each neuron consists of three basic components:
A polio infection often damages or destroys many of these motor neurons. To compensate for the resulting neuron shortage, the remaining neurons sprout new fibers, and the surviving motor units enlarge.
This promotes recovery of the use of your muscles, but it also pushes the nerve cell body to nourish the additional fibers. Over the years, this stress may be more than the neuron can handle, leading to the gradual deterioration of the sprouted fibers and, eventually, of the neuron itself.
Factors that can increase your risk of developing post-polio syndrome include:
Post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications:
Malnutrition, dehydration and pneumonia. People who've had bulbar polio, which affects nerves leading to muscles involved in chewing and swallowing, often have difficulty with these activities and have other signs of post-polio syndrome.
Chewing and swallowing problems can lead to inadequate nutrition and to dehydration, as well as to aspiration pneumonia, which is caused by inhaling food particles into your lungs (aspirating).
Chronic respiratory failure. Weakness in your diaphragm and chest muscles makes it harder to take deep breaths and cough, which can cause fluid and mucus to build up in your lungs.
Obesity, smoking, curvature of the spine, anesthesia, prolonged immobility and certain medications can further decrease your breathing ability, possibly leading to a sharp drop in blood oxygen levels (acute respiratory failure). You might then need treatment to help you breathe (ventilation therapy).
There's no diagnostic test for post-polio syndrome. Diagnosis is based on a medical history and physical exam, and exclusion of other conditions that could cause the signs and symptoms.
For a diagnosis of post-polio syndrome, doctors look for three indicators:
In addition, because the signs and symptoms of post-polio syndrome are similar to those of other disorders, your doctor will attempt to exclude other possible causes, such as arthritis, fibromyalgia, chronic fatigue syndrome and scoliosis.
Because there are no tests that confirm a post-polio syndrome diagnosis, your doctor may use certain tests to rule out other conditions, including:
Electromyography (EMG) and nerve conduction studies. Electromyography measures the tiny electrical discharges produced in muscles. A thin-needle electrode is inserted into the muscles to be studied. An instrument records the electrical activity in your muscle at rest and as you contract the muscle.
In a variation of EMG called nerve conduction studies, two electrodes are taped to your skin above a nerve to be studied. A small shock is passed through the nerve to measure the speed of nerve signals. These tests help identify and exclude conditions such as an abnormal condition of your nerves (neuropathy) and a muscle tissue disorder (myopathy).
A noninvasive test shows promise for evaluating the severity of post-polio syndrome and monitoring its progression is muscle ultrasound, which uses sound waves to create images of muscles. More study is needed.
There's no one treatment for the various signs and symptoms of post-polio syndrome. The goal of treatment is to manage your symptoms and help make you as comfortable and independent as possible:
Physical therapy. Your doctor or therapist may prescribe exercises for you that strengthen your muscles without fatiguing them. These usually include less strenuous activities, such as swimming or water aerobics, that you perform every other day at a relaxed pace.
Exercising to maintain fitness is important, but avoid overusing your muscles and joints and exercising to the point of pain or fatigue.
Other possible treatment options may include the anticonvulsant drug gabapentin (Neurontin, Gralise) which is often used to treat nerve pain. Chronic opioid pain medications generally shouldn't be used due to their long-term risks. You and your doctor should discuss the right treatment plan for you to manage your pain and symptoms.
Having to deal again with an illness you thought was in the past can be discouraging or even overwhelming at times. Recovering from the initial illness required drive and determination, but now the late effects of polio require you to rest and conserve your energy.
Here are some suggestions:
Dealing with the fatigue and weakness of post-polio syndrome can be difficult physically and psychologically. You might need to rely on your friends and family. Don't hesitate to tell them what kind of help you need.
Consider joining a support group for people with post-polio syndrome. Sometimes talking things over with people who have similar problems can help you cope. Ask your doctor about support groups in your area.
You're likely to start by seeing your family doctor. However, you'll likely be referred to a doctor who specializes in nervous system disorders (neurologist).
Here's some information to help you get ready for your appointment.
Make a list of:
For post-polio syndrome, basic questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you questions, including:
October 28th, 2021