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2.1
Postpoliomyelitis Syndrome
Muscular Atrophies Post Poliomyelitis

Presentation

It can present as dysphonia, with vocal weakness and fatigue. Swallowing, respiratory, and other laryngopharyngeal symptoms may be manifestations of the disease or they may represent worsening of previously stable and compensated deficits. [ncbi.nlm.nih.gov]

Sudhansu Chokroverty—a world-recognized expert in sleep medicine—presents the third edition of Sleep Disorders Medicine for the latest developments in this rapidly expanding specialty, with coverage of neuroscience and clinical application. [books.google.com]

Entire Body System

  • Fatigue

    MAIN OUTCOME MEASURES: The Fatigue Severity Scale (FSS), visual analog scale (VAS) for fatigue, and Fatigue Impact Scale (FIS). [ncbi.nlm.nih.gov]

  • Chronic Fatigue Syndrome

    View Article PubMed Google Scholar Packer TL, Sauriol A, Brouwer B: Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis. Archives of Physical Medicine & Rehabilitation. 1994, 75: 1122-1126. [bmcneurol.biomedcentral.com]

    It shares many features with chronic fatigue syndrome, but, unlike that disorder, it tends to be progressive and can cause loss of muscle strength. [en.wikipedia.org]

    It shares many features with the post-viral chronic fatigue syndrome, but unlike that disorder, it tends to be progressive, and as such can cause a tangible loss of muscle strength. [medicalmarijuana.com]

Musculoskeletal

  • Muscle Weakness

    "minor illnesses," can be associated with acute central nervous system damage and late-onset muscle weakness and fatigue. [doi.org]

    The symptoms are new muscle weakness, decreased muscle endurance, fatigue, muscle pain, joint pain, cold intolerance, and this typical clinical entity is reported from different parts of the world. [dovepress.com]

    Muscle fatigue is linked to muscle weakness and muscle atrophy, and those with more pronounced muscle weakness also experience more muscle fatigue. Fatigue can also be described as more generalized and of central origin. [clinicalgate.com]

  • Muscular Atrophy

    The rate of progression of post-poliomyelitis muscular atrophy is quite variable. [nejm.org]

    The symptoms and signs of PPS include new muscle weakness and atrophy (post-poliomyelitis progressive muscular atrophy; PPMA),as well as other musculoskeletal symptoms such as fatigue, skeletal deformity, and pain. [ci.nii.ac.jp]

    This muscle weakness may or may not be accompanied by fatigue, myalgia, muscular atrophy and subsequent loss of functionality. If electromyographic changes are seen, we can see that is truly a post-polio syndrome (Halstead's criteria). [guttmann.com]

  • Myopathy

    Part two then addresses the complete range of specific neuromuscular diseases: neuronopathies, peripheral neuropathies, neuromuscular junction disorders, muscle ion channel disorders, myopathies, and miscellaneous neuromuscular disorders and syndromes [books.google.com]

    A history of more rapid progression of muscle weakness during weeks or months could indicate an alternative diagnosis, such as myopathy (e.g., polymyositis, thyroid myopathy), peripheral nerve disorders, or motor neuron disorder (e.g., amyotrophic lateral [clinicalgate.com]

    Post polio syndrome, spinal cord injury and statin myopathy: double trouble or incorrect diagnosis? Two case reports. J Rehabil Med 2011; 43:734-735. 4. Gunnar G, Jianan Li, Carol V, M. Elizabeth S. [jpma.org.pk]

    The neurological deterioration and functional decline of post-polio syndrome may be related to normal aging, overuse myopathy and disuse. [now.aapmr.org]

    […] poliomyelitis and post-poliomyelitis syndrome: Other neurologic syndromes that may be confused with poliomyelitis or PPS include ALS, Guillain-Barre syndrome, West Nile virus, other non-polio enteroviruses, diphtheria, botulism, radiculopathy, neuropathy, and myopathy [clinicaladvisor.com]

  • Myalgia

    This muscle weakness may or may not be accompanied by fatigue, myalgia, muscular atrophy and subsequent loss of functionality. If electromyographic changes are seen, we can see that is truly a post-polio syndrome (Halstead's criteria). [guttmann.com]

    Record Dates Last Update Posted: November 17, 2015 Last Verified: November 2015 Keywords provided by Biolab Sanus Farmaceutica: Postpoliomyelitis Syndrome Piracetam L-Carnitine Additional relevant MeSH terms: Layout table for MeSH terms Syndrome Fatigue Myalgia [clinicaltrials.gov]

    In addition to the initial symptoms, the patient reported fatigue when walking and myalgias with weakness in the left lower limb. [scielo.org.co]

    Myalgias - polymyalgia rheumatica, fibromyalgia. Management [ 4 ] Editor's note August 2018 - Dr Hayley Willacy recommends the guide to management of post-polio syndrome for healthcare professionals [ 11 ]. [patient.info]

    […] respiratory problems (14%) Placebo: cold virus (6%), heartburn (6%), insomnia (3%), sinusitis (6%), diarrhoea (3%), dry eyes (6%), joint or back pain (6%), headache (3%) Farbu 2007 IVIG 2g/kg body weight, 1 infusion Medication: flu‐like illness and chest myalgia [doi.org]

  • Muscle Cramp

    However, at the age of 48, he developed left sided lower limb weakness, generalized aches and pains and muscle cramps. These symptoms have been progressively worsening for past 2 years. [jpma.org.pk]

    These late symptoms are referred to as Postpoliomyelitis Syndrome (PPS) and include new or increased muscle weakness, abnormal muscle fatigability, generalized fatigue, muscle atrophy, muscle and joint pain, muscle cramps and cold intolerance [ 1 ]. [bmcneurol.biomedcentral.com]

    […] and gastrointestinal cramp and 5. nausea, diarrhoea, vomiting and faintness) Placebo: 1 patient (2%) angina, shortness of breath Medication: 7 patients (11%) muscle cramps, abdominal pain, nausea, diarrhoea, profuse sweating, chest pain, fractured fibula [doi.org]

Workup

There is no diagnostic test for PPS, and the diagnosis is based on a proper clinical workup where all other possible explanations for the new symptoms are ruled out. [dovepress.com]

ADLs Inability to Initiate Meaningful Activities Anxiety Spatial Disorientation Rejection of Care Food Refusal Insomnia Apathy and Agitation Elopement and Interference with Others References Introduction Epidemiology Challenges in Geriatric Psychiatry WorkUp [books.google.com]

The prevalence of PPS has been reported to be between 20% and 85% of people who have had poliomyelitis. [2] There is no diagnostic test for PPS, and the diagnosis is based on a proper clinical workup where all other possible explanations for the new symptoms [mjdrdypu.org]

Treatment

Physical Therapy Surgery References Introduction Effects of Ageing and Related Diseases on Endocrine Diseases The Hormonal Fountain of Youth References Introduction Water Homeostasis in the Elderly Workup and Treatment of Hyponatraemia Workup and Treatment [books.google.com]

The effectiveness of pharmacological treatment and rehabilitation management in PPS is not yet established. Objectives To review systematically the effects of any treatment for PPS compared to placebo, usual care or no treatment. [doi.org]

The results of this study will generate new evidence for the rehabilitation treatment of persons with PPS. TRIAL REGISTRATION: Dutch Trial Register NTR1371. [ncbi.nlm.nih.gov]

Exclusion Criteria: History of intolerance to L-carnitine or piracetam; Treatment with L-carnitine during the past 3 months; Treatment with piracetam or any other nootropics pyrrolidone derivatives, during the past three months; Anemia (hemoglobin reference [clinicaltrials.gov]

Prognosis

When unilateral, the prognosis is good, but bilateral diaphragmatic paralysis often has a worse prognosis. • Supportive care, self-selected life style changes, and energy conservation strategies still remain the main axiom of therapy. • Post-polio patients [medlink.com]

The prognosis also differs depending upon different causes and factors affecting the individual. [en.wikipedia.org]

Differential diagnosis and prognosis. In: Halstead LS, Grimby G, eds. Post-polio syndrome. Philadelphia: Hanley & Belfus, 1995, pp. 69-88. Google Scholar 9. Gawne AC. Strategies for exercise prescription in post-polio patients. [link.springer.com]

Prognosis Prognosis for patients with post polio syndrome is relatively good. It is a very slow, gradually progressing syndrome. Only about 20% of all patients with PPS will need to rely on new aids for mobility or breathing. [encyclopedia.com]

Treatment can improve both quality of life and prognosis. Aetiology Respiratory problems in PPS may be due to one or more of: Respiratory muscle weakness. Bulbar impairment - this may affect control of the upper airway or the respiratory cycle. [patient.info]

Etiology

We review possible etiologies of laryngeal PPS, diagnostic criteria, and treatment, as well as the current literature. [ncbi.nlm.nih.gov]

[…] postpoliomyelitis syndrome [ pōst-po″le-o-mi-ĕ-li´tis ] a group of symptoms of unknown etiology seen in patients several years to many years after they have recovered from the major illness of poliomyelitis ; it includes new weakness, fatigue, and pain [medical-dictionary.thefreedictionary.com]

[…] time in various reports from the acute poliomyelitis until the onset of PPS is about 35 years, with a range from 8 to 71 years. 1 However, it is unclear if the occurrence of PPS increases with aging, which may be the case based on the most accepted etiologic [doi.org]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Epidemiology

Ramlow, Epidemiology Department, Dow Chemical Co., 1803 Building, Midland, MI 48674 Search for other works by this author on: Jonathan Ramlow 2 Alfred I. [doi.org]

Homes Successful Ageing Future Research Introduction Developments in the UK 20052010 Services Patients Views and Involvement Additional Responsibilities for Geriatric Psychiatry Services Other Issues An International Perspective References Introduction Epidemiology [books.google.com]

Epidemiology of the post-polio syndrome. Am J Epidemiol. 1992 Oct 1. 136(7):769-86. [Medline]. Quadros AA, Conde MT, Marin LF, Silva HC, Silva TM, Paula MB, et al. [emedicine.com]

Pathophysiology

The pathophysiology behind PPS is not fully understood, but a combination of distal degeneration of enlarged motor units caused by increased metabolic demands and the normal aging process, in addition to inflammatory mechanisms, are thought to be involved [dovepress.com]

[…] of the Ageing Bladder Special Disease States Pharmacology as it Relates to the Ageing Bladder Surgical Disease of the Ageing Bladder Conclusion References Introduction Benign Prostatic Hyperplasia Prostate Cancer Prostatitis References Introduction Pathophysiology [books.google.com]

Prevention

Aging with Polio and Preventing Secondary Disability 13. Energy Conservation and Pacing 14. Gait, Bracing, Shoes and Assistive Devices 15. Motorized mobility 16. Complimentary and Alternative Medicine 17. [elsevier.com]

CONCLUSIONS: These findings suggest that work-oriented interventions aimed at preventing PPS patients from dropping out of the workforce should primarily focus on reducing physical job demands, arranging adaptations in the workplace and increasing job [ncbi.nlm.nih.gov]

Centers for Disease Control and Prevention Polio: Information for Parents (American Academy of Family Physicians) Polio: Information for Parents (American Academy of Pediatrics) Polio: Information for Parents (Centers for Disease Control and Prevention [icdlist.com]

[…] avoided through preventive measures. [now.aapmr.org]

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