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Poliomyelitis/Post-Polio Syndrome

Condition: Acute poliomyelitis is a virus that can invade the central nervous system and cause paralysis. Post-polio syndrome (PPS) is a progressive disorder of the nerves and muscles that can occur in survivors of paralytic polio usually after 15 or more years.

Background: Two percent of patients with polio develop paralysis, and 40 percent of polio survivors develop PPS.

Risk Factors: Patients at risk for PPS are those who had a severe case of acute paralytic poliomyelitis, were older when they contracted the virus, and have a permanent impairment with some degree of disability. Weight gain, age, an increase or decrease in activity level, trauma, surgery, and joint pain also are associated with increased risk.

History and Symptoms: Symptoms of acute paralytic polio include fever and sudden onset of paralysis. PPS symptoms, which can develop suddenly or progress slowly, typically include new weakness, muscle fatigue, and muscle and/or joint pain. In some cases, patients experience difficulty breathing.

Physical Exam: In addition to confirming previous polio infection, patients undergo a physical exam to identify musculoskeletal problems (such as spine and joint deformities) and to rule out other neurological conditions.

Diagnostic Process: To diagnose PPS, healthcare providers evaluate a patient’s symptoms and mobility. X-rays can assess bone and joint pain and deformities; MRI or CT scans rule out other neurological conditions; and pulmonary function tests evaluate breathing difficulty.

Rehab Management: Weight control and avoiding overuse of muscles may prevent or delay the onset of PPS. Treatment usually involves recommending that patients have regular rest periods during the day, modify their activity level, use assistive devices and orthotics, or begin an exercise program. Anti-inflammatory medications, muscle relaxants and physical therapy may help reduce pain.

Other Resources for Patients and Families: Online resources and education materials are available from Post-Polio Health International. Local post-polio support groups also can provide information and psychological support.

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