eMedicine Specialties > Physical Medicine and Rehabilitation > Disorders of the Motor Unit

Postpolio Syndrome: Follow-up

Author: Flor M Muñiz, MD, Assistant Professor, Department of Physical Medicine and Rehabilitation, McMaster University, Hamilton, Ontario
Coauthor(s): Gerald J Herbison, MD, Professor, Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University
Contributor Information and Disclosures

Updated: May 6, 2009

Follow-up

Prognosis

  • The symptoms of postpolio syndrome are slowly progressive, with periods of stability from 3-10 years.

Miscellaneous

Medicolegal Pitfalls

  • Postpolio syndrome (PPS) might be mistaken for any of the conditions described in the differential diagnosis. Because of this possibility, failure to diagnose PPS properly could lead the physician to administer medications or treatments to the patient that do not correspond to the pathology process, thereby not improving the patient's condition and possibly resulting in multiple adverse effects to the patient from the medications used.

Special Concerns

  • Certain psychological issues have been studied in relation to postpolio syndrome (PPS), including the following:
    • Most studies reveal that depression is not related to PPS symptomatology or to the level of residual physical disability.
    • Type A behavior is significantly higher in the polio population than in a control population.
    • Overall, normal psychological and emotional functioning has been found in patients with PPS, compared with controls.
 


More on Postpolio Syndrome

Overview: Postpolio Syndrome
Differential Diagnoses & Workup: Postpolio Syndrome
Treatment & Medication: Postpolio Syndrome
Follow-up: Postpolio Syndrome
References
Further Reading
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References

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  3. Fordyce CB, Gagne D, Jalili F, et al. Elevated serum inflammatory markers in post-poliomyelitis syndrome. J Neurol Sci. Aug 15 2008;271(1-2):80-6. [Medline].

  4. Stoelb BL, Carter GT, Abresch RT, et al. Pain in persons with postpolio syndrome: frequency, intensity, and impact. Arch Phys Med Rehabil. Oct 2008;89(10):1933-40. [Medline].

  5. Correa JC, Rocco CC, de Andrade DV, et al. Electromyographic and neuromuscular analysis in patients with post-polio syndrome. Electromyogr Clin Neurophysiol. Nov-Dec 2008;48(8):329-33. [Medline].

  6. Skough K, Krossen C, Heiwe S, et al. Effects of resistance training in combination with coenzyme Q10 supplementation in patients with post-polio: a pilot study. J Rehabil Med. Oct 2008;40(9):773-5. [Medline].

  7. Gonzalez H, Sunnerhagen KS, Sjoberg I, et al. Intravenous immunoglobulin for post-polio syndrome: a randomised controlled trial. Lancet Neurol. Jun 2006;5(6):493-500. [Medline].

  8. On AY, Oncu J, Uludag B, et al. Effects of lamotrigine on the symptoms and life qualities of patients with post polio syndrome: a randomized, controlled study. NeuroRehabilitation. 2005;20(4):245-51. [Medline].

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  10. Agre JC. The role of exercise in the patient with post-polio syndrome. Ann N Y Acad Sci. May 25 1995;753:321-34. [Medline].

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  13. Dalakas MC. Pathogenetic mechanisms of post-polio syndrome: morphological, electrophysiological, virological, and immunological correlations. Ann N Y Acad Sci. May 25 1995;753:167-85. [Medline].

  14. Dalakas MC. The post-polio syndrome as an evolved clinical entity. Definition and clinical description. Ann N Y Acad Sci. May 25 1995;753:68-80. [Medline].

  15. Diseases of the motor unit. In: DeLisa J, Gans B, eds. Rehabilitation Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa: Lippincott-Raven; 1998:1554-6.

  16. Dinsmore S, Dambrosia J, Dalakas MC. A double-blind, placebo-controlled trial of high-dose prednisone for the treatment of post-poliomyelitis syndrome. Ann N Y Acad Sci. May 25 1995;753:303-13. [Medline].

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  23. Maselli RA, Wollmann R, Roos R. Function and ultrastructure of the neuromuscular junction in post-polio syndrome. Ann N Y Acad Sci. May 25 1995;753:129-37. [Medline].

  24. Okumura H, Kurland LT, Waring SC. Amyotrophic lateral sclerosis and polio: is there an association?. Ann N Y Acad Sci. May 25 1995;753:245-56. [Medline].

  25. Ring D, Vaccaro AR, Scuderi G. An association between the flat back and postpolio syndromes: a report of three cases. Arch Phys Med Rehabil. Mar 1997;78(3):324-6. [Medline].

  26. Semino-Mora C, Dalakas MC. Rimmed vacuoles with beta-amyloid and ubiquitinated filamentous deposits in the muscles of patients with long-standing denervation (postpoliomyelitis muscular atrophy): similarities with inclusion body myositis. Hum Pathol. Oct 1998;29(10):1128-33. [Medline].

  27. Shetty KR, Gupta KL, Agre JC. Effect of human growth hormone on muscle function in post-polio syndrome. Ann N Y Acad Sci. May 25 1995;753:386-9. [Medline].

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  29. Sonies BC, Dalakas MC. Progression of oral-motor and swallowing symptoms in the post-polio syndrome. Ann N Y Acad Sci. May 25 1995;753:87-95. [Medline].

  30. Spector SA, Gordon PL, Yildiz E. Effect of strength training in patients with post-polio syndrome. A preliminary report. Ann N Y Acad Sci. May 25 1995;753:402-4. [Medline].

  31. Stein DP, Dambrosia JM, Dalakas MC. A double-blind, placebo-controlled trial of amantadine for the treatment of fatigue in patients with the post-polio syndrome. Ann N Y Acad Sci. May 25 1995;753:296-302. [Medline].

  32. Thorsteinsson G. Management of postpolio syndrome. Mayo Clin Proc. Jul 1997;72(7):627-38. [Medline].

  33. Trojan DA, Cashman NR. Anticholinesterases in post-poliomyelitis syndrome. Ann N Y Acad Sci. May 25 1995;753:285-95. [Medline].

  34. Trojan DA, Collet JP, Shapiro S. A multicenter, randomized, double-blinded trial of pyridostigmine in postpolio syndrome. Neurology. Oct 12 1999;53(6):1225-33. [Medline].

  35. van Kralingen KW, Ivanyi B, van Keimpema AR. Sleep complaints in postpolio syndrome. Arch Phys Med Rehabil. Jun 1996;77(6):609-11. [Medline].

  36. Windebank AJ, Litchy WJ, Daube JR. Lack of progression of neurologic deficit in survivors of paralytic polio: a 5-year prospective population-based study. Neurology. Jan 1996;46(1):80-4. [Medline].

  37. Windebank AJ, Litchy WJ, Daube JR. Prospective cohort study of polio survivors in Olmsted County, Minnesota. Ann N Y Acad Sci. May 25 1995;753:81-6. [Medline].

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Further Reading

Clinical guidelines:
EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force.
European Federation of Neurological Societies - Medical Specialty Society.  2006 Aug.  7 pages.  NGC:005488

Clinical trials:
Study of Mental Fatigue in Polio Survivors

Related eMedicine topics:
 Acute Poliomyelitis
Breathing-Related Sleep Disorder
Central Sleep Apnea
Enteroviral Infections
Enteroviruses
Focal Muscular Atrophies
Obstructive Sleep Apnea-Hypopnea Syndrome
Poliomyelitis [Orthopedic Surgery]
Poliomyelitis [Pediatrics: General Medicine]
Swallowing Disorders

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Keywords

postpolio syndrome, polio, poliomyelitis, muscle atrophy, post polio, post polio syndrome, sleep apnea, neuromuscular junction, enterovirus, polio virus, poliovirus, denervation, post-polio syndrome, polio complications

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Contributor Information and Disclosures

Author

Flor M Muñiz, MD, Assistant Professor, Department of Physical Medicine and Rehabilitation, McMaster University, Hamilton, Ontario
Flor M Muñiz, MD is a member of the following medical societies: American Medical Association, Canadian Association of Physical Medicine and Rehabilitation, and Canadian Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Gerald J Herbison, MD, Professor, Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University
Disclosure: Nothing to disclose.

Medical Editor

Martin K Childers, DO, PhD, Associate Professor, Department of Neurology, Wake Forest University Health Services
Martin K Childers, DO, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Congress of Rehabilitation Medicine, American Osteopathic Association, Christian Medical & Dental Society, and Federation of American Societies for Experimental Biology
Disclosure: Allergan pharma Consulting fee Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Kat Kolaski, MD, Assistant Professor, Departments of Orthopedic Surgery and Pediatrics, Wake Forest University School of Medicine
Kat Kolaski, MD is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine and American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Denise I Campagnolo, MD, MS, Director of Multiple Sclerosis Clinical Research and Staff Physiatrist, Barrow Neurology Clinics, St Joseph's Hospital and Medical Center; Investigator for Barrow Neurology Clinics; Director, NARCOMS Project for Consortium of MS Centers
Denise I Campagnolo, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, Association of Academic Physiatrists, and Consortium of Multiple Sclerosis Centers
Disclosure: Teva Neuroscience Honoraria Speaking and teaching; Serono-Pfizer Honoraria Speaking and teaching

 
 
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