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Post Polio Syndrome

What is Neuro-rehabilitation?

Post-polio syndrome (PPS) is a disorder of the nerves and muscles. It happens in some people many years after they have had polio. PPS may cause new muscle weakness that gets worse over time, pain in the muscles and joints, and tiredness. People with PPS often feel exhausted.

Polio is a contagious disease caused by the polio virus. It can spread through body fluids. It most often strikes young children. Severe polio may lead to paralysis and breathing problems.

Symptoms of polio can range from a mild, flu-like illness to serious muscle paralysis. Many people who survive polio are later at risk for PPS.

PPS happens in some people who have recovered from polio. It starts an average of 35 years after the original polio and may eventually make it hard to breathe. PPS may cause the muscles to shrink.

What are the symptoms of post-polio syndrome?

PPS affects your nerves and muscles. Symptoms usually start between 20 and 40 years after the original polio illness. But they may appear anywhere from 10 to 70 years after. Muscle weakness may be the main symptom. This weakness may affect one side of your body more than the other. In general, symptoms of PPS may include:

  • Progressive weakness (common)
  • Tiredness (fatigue) (common)
  • Pain in the muscles and joints (common)
  • Muscle shrinkage
  • Trouble swallowing
  • Breathing problems
  • Sleep disorders
  • Sensitivity to cold temperatures

You may find that your symptoms get more noticeable. Nerves and muscles may continue to decline over time. Specially designed exercise programs and physical therapy may help improve some of the muscle weakness

How is post-polio syndrome diagnosed?

PPS only develops in people who once had polio. Your healthcare provider will ask about your health history, your recent symptoms, and other health conditions. The provider typically does a physical exam and tests your muscle strength. You may need testing that includes:

  • Blood tests to rule out other causes for your muscle weakness
  • Electromyography (EMG)_to measure the electrical activity of the muscles
  • Muscle biopsy to look for signs of damage in the muscle cells
  • MRI or CT scans

Your healthcare provider may make a diagnosis of PPS if you had polio in the past, have new muscle weakness and other symptoms that last for a year, and have no other cause for your symptoms.

You may first see your primary healthcare provider and then be referred to a specialist, such as a neurologist who specializes in neuromuscular diseases.

How is post-polio syndrome treated?

There is no cure for PPS. But supportive therapies can help you manage the condition. The goal of treatment for PPS is to reduce the impact of the condition on your daily life. You may use a cane or walker to save your energy and muscle strength. You may need to make sure you get plenty of rest.

People with PPS who have new muscle weakness and tiredness (fatigue) may improve muscle strength with specially designed, low-intensity muscle-strengthening exercise programs known as non-fatiguing exercises. You may do these exercises in brief cycles, in which short repeats of exercise alternate with periods of rest in between. It's very important for people with PPS to not do too much exertion. Exercising in warm temperatures and in water may improve your well-being.

In addition to the exercise program, other supportive therapies that you may use include:

  • Assistive devices such as lightweight braces, canes, walkers, scooters, and wheelchairs
  • Medicines to ease pain
  • Medicines to ease fatigue
  • Physical therapy to keep as much mobility as possible
  • Occupational therapy to help with ways to adapt
  • Speech-language therapy if needed for trouble swallowing
  • Assisted breathing with a positive-pressure breathing machine, if needed, especially at night
  • Emotional and mental health support

You may get care from a variety of providers in addition to your neurologist. These might include physical therapists, occupational therapists, speech-language therapists, and respiratory specialists. You can work with your medical team to design the best plan of care for your situation.