$Unique_ID{BRK04133} $Pretitle{} $Title{Post-Polio Syndrome} $Subject{Post-Polio Syndrome Polio, Late Effects Post-Polio Muscular Atrophy Post-Polio Sequelae Poliomyelitis (Infantile Paralysis)} $Volume{} $Log{} Copyright (C) 1987, 1989, 1991, 1992 National Organization for Rare Disorders, Inc. 476: Post-Polio Syndrome ** IMPORTANT ** It is possible the main title of the article (Post-Polio Syndrome) is not the name you expected. Please check the SYNONYMS listing on the next page to find alternate names, disorder subdivisions, and related disorders covered by this article. Synonyms Polio, Late Effects Post-Polio Muscular Atrophy Post-Polio Sequelae Information on the following disorder can be found in the Related Disorders section of this report: Poliomyelitis (Infantile Paralysis) General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Post-Polio Syndrome is characterized by a history of Poliomyelitis at least ten years previously, and partial recovery of function followed by development of progressive weakness in previously affected muscles for which there is no other definite cause. Symptoms Post-Polio Syndrome occurs at least 10 years after a person has been stricken by polio. It is characterized by gradual deterioration of muscle function and increased weakness which usually occurs in the limbs that had been most severely affected by polio. Sometimes the disorder involves those muscles apparently fully recovered or previously uninvolved, including muscles necessary for respiration. Other symptoms may include fatigue, muscle pain and twitching (fasciculations). (For more information on this disorder, see "A Fearful Reminder Stalks Polio's Survivors" and "What Is Polio?" in the Prevalent Health Conditions/Concerns area of NORD Services.) Causes The exact cause of Post-Polio syndrome has not yet been identified. Theories that the dormant polio virus may be reactivated years after polio first occurs are now the most popular theories. Other theories that Post-Polio patients appear to be aging more rapidly in certain parts of their central nervous system than their peers are also unproven. Recently, scientists determined that Post-Polio Syndrome is not a form of Amyotrophic Lateral Sclerosis (ALS). (For more information on this disorder, choose ALS as your search term in the Rare Disease Database.) In a 1987 study of Post-Polio Syndrome patients, scientists found evidence that nerve cells in affected muscles may grow many small sprouts from the message-transmitting axons of healthy nerve cells during recovery from polio. These sprouts take over the function of neurons killed by the polio virus. After years of functioning beyond capacity, the nerve cells can weaken and lose the ability to maintain these sprouts, which then begin to shrink, and the whole muscle becomes weaker. As a result of this discovery, researchers hope to develop an experimental treatment that may improve sprouting of the axons. Other studies, such as investigating the presence of abnormal proteins in cerebrospinal fluid, and the effect of the polio virus on nerve cells in muscle fibers of Post-Polio patients. Affected Population Post-Polio Syndrome affects about 20% of people who have recovered from Poliomyelitis more than 10 years previously. Symptoms can appear 30 or more years after onset of Polio. Related Disorders Symptoms of the following disorder are similar to those of Post-Polio Syndrome. Comparisons may be useful for a differential diagnosis: Poliomyelitis (Infantile Paralysis or "Polio") is an acute virus infection most often affecting children. It may occur in individual cases, or in epidemic outbreaks. The disorder is caused by a virus that affects parts of the brain and spinal cord (central nervous system). Muscles no longer receive strong nerve signals telling them how to move. The result is paralysis that can be life threatening when it affects breathing and swallowing. Painful muscle spasms in arms and legs may also occur. Recovery from a serious bout with Polio is slow. Residual effects such as limb and body weakness and paralysis can last a lifetime. The Salk and Sabin vaccines, introduced in the 1950's and 1960's, have virtually eliminated Polio in the United States and have greatly reduced its incidence throughout the world. The Centers for Disease Control (CDC) reported that polio is almost eradicated from the Western Hemisphere. In 1991 there were only nine cases of polio identified in the Americas. Therapies: Standard People who had Polio before the polio vaccine was developed should be evaluated to determine if they have Post-Polio Syndrome. This would include comprehensive muscle testing and gait analysis plus a complete physical examination. Physical therapy, occupational therapy, changes in braces, and/or changes in diet may be helpful. Excess weight is particularly disabling when muscles are weakened. Rehabilitation, rest and medication may also be prescribed. Swimming is the best form of exercise for Post-Polio patients, but other forms of exercise, not exceeding 5 to 20 minutes with rest periods in between, may also be advised by a physician. Use of a respirator such as a mouth intermittent positive pressure ventilation system may be prescribed if breathing is affected. Therapies: Investigational This disease entry is based upon medical information available through September 1992. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Post-Polio Syndrome, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Post-Polio National, Inc. (Post-Polio League for Information and Outreach) 3581 University Drive Fairfax, VA 22030 (703) 273-8171 Polio Information Center 510 Main Street, Suite A446 Roosevelt Island, NY 10044 (212) 223-0353 British Polio Fellowship Bell Close West End Ruislip, Middlesex HA4 6LP England International Polio Network 5100 Oakland Ave., #206 St. Louis, MO 63110, U.S.A. (314) 534-0475 Centers for Disease Control 1600 Clifton Road, NE Atlanta, GA 30333 (404) 639-3534 For rehabilitation services contact: National Easter Seal Society for Crippled Children and Adults 70 East Lake St. Chicago, IL 60601 (312) 726-6200 (voice) (312) 726-4258 (TDD) References MOUTH INTERMITTENT POSITIVE PRESSURE VENTILATION IN THE MANAGEMENT OF POSTPOLIO RESPIRATORY INSUFFICIENCY: J.R. Bach, et al.; Chest (June 1987: issue 91(6)). Pp. 859-864. HANDBOOK OF THE LATE EFFECTS OF POLIOMYELITIS FOR PHYSICIANS AND SURVIVORS: Gini Laurie, et al., ed.; G.I.N.I. 1984. LATE EFFECTS OF POLIOMYELITIS: Lauro Halstead, et al., ed.; Symposia Foundation, 1984.