Post-Polio Syndrome

What is post-polio syndrome?

Post-polio syndrome (PPS) is a condition that affects polio survivors 10 to 40 years after they had polio. PPS causes loss of muscle function, fatigue, weakness, and trouble swallowing. About 25% of polio survivors develop PPS.

How does it occur?

The cause of PPS is not completely understood. The original poliovirus infection attacked nerve cells responsible for muscle movement. This caused injury or death of these nerve cells. Surviving nerve cells sprouted extra branches. These branches attached to muscles that had lost their original nerve supply during the polio infection. After the new nerves reattached, the muscles were able to work again. Some researchers think that PPS develops because these extra nerve sprouts weaken over time. The muscle again loses its ability to move properly.

What are the symptoms?

Symptoms of PPS are:

• fatigue
• increasing muscle weakness
• trouble swallowing
• wasting away of muscles (atrophy)
• joint pain
• skeletal problems, such as scoliosis (curvature of the spine).

How is it diagnosed?

Your health care provider will test how well your nerves work. You may also have such tests as:

• imaging tests, or scans, such as MRI, CT, and PET
• tests of samples of muscle tissue (biopsies)
• tests of spinal fluid.

How is it treated?

No current treatment can cure or prevent PPS. Some experimental drug treatments, including pyridostigmine and selegiline, may help. The future in PPS treatment may focus on helping to grow new nerve sprouts.

How long will the effects last?

PPS worsens very slowly. There may be long periods of time when it does not worsen. Unless you have severe lung problems, PPS is not usually life threatening.

How can I take care of myself?

• Manage new weakness with strengthening, stretching, and aerobic exercises. Avoid exercise that causes joint pain. Do not exercise to the point of muscle pain or fatigue.
• Conserve your energy.
• Learn to pace daily activities.
• Have regular rest periods or daytime naps, especially in the early afternoon.
• Take pain relievers such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs such as ibuprofen (such as Advil), naproxen (such as Naprelan or Aleve), and etodolac (Lodine).
• Put ice or heat on your muscles, or use transcutaneous electrical nerve stimulation (TENS), to help relieve pain.
• Consider using devices that can help you be mobile, such as canes, crutches, wheelchairs, and motorized scooters.
• If you used a ventilator during your original polio infection, you may need to use a ventilator again.
• Manage swallowing problems by:
  • eating smaller and more frequent meals during the day
  • avoiding eating when fatigued
  • turning your head to one side or tucking down your chin while swallowing.

For more information, contact:

International Polio Network/Gazette International
4207 Lindell Boulevard, #110
St. Louis, Missouri 63108-2915
314-534-0475
Web site: http://www.post-polio.org