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.
Symptoms
The main clinical features are new weakness, muscular fatigability, general fatigue, and pain. Cold intolerance, difficulty in swallowing and breathing, sleep disorders, and worsening functional abilities are also seen.
Risk factors
Factors that can increase your risk of developing post-polio syndrome include:
Severity of initial polio infection. The more severe the initial infection, the more likely that you’ll have signs and symptoms of post-polio syndrome.
Age at onset of initial illness. If you developed polio as an adolescent or adult rather than as a child, your chances of developing post-polio syndrome increase.
Recovery. The greater your recovery after acute polio, the more likely it seems that post-polio syndrome will develop, perhaps because greater recovery places additional stress on motor neurons.
Excessive physical activity. If you often exercise to the point of exhaustion or fatigue, you might overwork already stressed-out motor neurons and increase your risk of post-polio syndrome.
Diagnosis
Post-polio syndrome is difficult to diagnose since the symptoms of presentation are usually non-specific. Predominantly, it is diagnosed by exclusion.
Prior polio infection
A period of recovery after the first polio attack, followed by a period of long term stability
Slowly increasing and constant new muscle weakness
Less endurance with or without fatigue
Muscle atrophy (shrinkage), or muscle and joint pain.
Symptoms that persist for at least a year.
Complications
Post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications:
Falls. Weakness in your leg muscles makes it easier for you to lose your balance and fall. You then might break a bone, such as a hip, leading to other 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 as well as 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).
Osteoporosis. Prolonged inactivity and immobility are often accompanied by loss of bone density and osteoporosis in both men and women. If you have post-polio syndrome, talk to your doctor about bone-density screening.
Treatment
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.
Medications. Pain relievers — such as aspirin, acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others) — might ease muscle and joint pain.
References :
www.ninds.nih.gov