Overview
Post-polio syndrome is a condition that affects individuals who had polio in their earlier years. Decades after the initial polio illness, a range of potentially disabling signs and symptoms may appear, including muscle and joint weakness, pain, fatigue, loss of muscle tissue (atrophy), and respiratory problems. These symptoms typically emerge between 30 to 40 years after the initial polio infection. The weakness and pain caused by post-polio syndrome tend to worsen over time, impacting daily activities and quality of life.
Understanding the disease
Symptoms
The symptoms of post-polio syndrome include muscle and joint weakness and pain that worsens over time, easy fatigue and exhaustion, loss of muscle tissue (atrophy), breathing or swallowing problems, sleep-related breathing disorders such as sleep apnea, decreased tolerance to cold temperatures, and falls due to weak leg muscles. Other symptoms may include chronic pain, malnutrition, dehydration, and pneumonia, difficulty chewing and swallowing, and decreased mobility.
Risk Factors
The risk factors for developing post-polio syndrome include the severity of the initial polio infection, age at onset of the initial illness, and recovery after the acute polio illness. Those who had polio as an adolescent or adult have a higher chance of developing post-polio syndrome. Additionally, people who had a more severe initial polio infection or a greater recovery after acute polio might also be at a higher risk. Other factors that can increase the risk are excessive physical activity, obesity, smoking, curvature of the spine, anesthesia, prolonged immobility, and certain medications.
Development
Post-polio syndrome (PPS) is believed to develop due to a combination of factors, including the natural aging process, overuse of the polio survivor's muscles and nerve cells, and structural changes in the motor neurons. After a polio infection, some motor neurons are damaged or destroyed, and the remaining neurons compensate by sprouting new fibers and growing larger. This process, called reinnervation, allows for some recovery of muscle function. However, over time, this compensation may lead to increased stress on the nerve cell body, resulting in the gradual breakdown of the sprouted fibers and eventually the neuron itself. Other theories suggest that post-polio syndrome may be caused by changes in the immune system, inflammation, or altered signaling between nerves and muscles. However, the exact cause of PPS is not yet fully understood.
Assessment and Diagnosis
Triage
You should see a doctor if you have increasing weakness, fatigue, or any other signs and symptoms of post-polio syndrome. It is important to rule out other causes of your symptoms and determine if you have post-polio syndrome.
Diagnosis
Diagnosing post-polio syndrome is primarily based on a medical history and physical examination, along with the exclusion of other conditions that could cause similar symptoms. There are no specific tests to diagnose post-polio syndrome. Doctors look for three indicators to diagnose post-polio syndrome:
- Previous diagnosis of polio
- Long interval after recovery, typically starting at least 15 years after the initial diagnosis
- Gradual onset of weakness in muscles that were previously affected by the initial polio illness To rule out other conditions, your doctor may perform blood tests, imaging studies like MRI or CT scans, or a muscle biopsy. Treatment for post-polio syndrome aims to manage symptoms and improve quality of life, but there is no specific cure for the condition.
Management and Treatment
Complications
Complications of post-polio syndrome can include falls, chronic respiratory failure, osteoporosis, sleep disorders, fatigue, pain, malnutrition, dehydration, and pneumonia.
Treatment
Post-polio syndrome is a condition that affects individuals who have had polio in the past. Treatment options for post-polio syndrome may include pain relievers like aspirin, acetaminophen, or ibuprofen to ease muscle and joint pain. Other possible treatments are anticonvulsant drugs such as gabapentin, and discussing the appropriate treatment plan with your doctor is crucial. Self-care strategies include limiting activities that cause pain or fatigue, resting and conserving energy, and seeking support from friends, family, or support groups. In addition, it is important to communicate effectively with your doctor by making a list of your symptoms, medical history, and any questions you may have. A neurologist specializing in nervous system disorders may be consulted for further evaluation and treatment.
Preparing for medical consultation
To prepare for an appointment for post-polio syndrome, you should:
- Make a list of your symptoms, including those that may seem unrelated to post-polio syndrome, along with their onset.
- Gather key personal information, such as major stresses or recent life changes, medical history, and family medical history.
- List all medications, vitamins, or supplements you are currently taking, including doses.
- Prepare a list of questions to ask your doctor, such as the cause of your symptoms, possible alternative causes, necessary tests, the nature of your condition, available treatments, and how to manage other health conditions.
- Be prepared to discuss your previous polio diagnosis, the time elapsed since recovery, and any other relevant medical history.