Q: A couple of years ago you wrote about a gait abnormality being puzzling to diagnose. Well, I thought I would pass this on to you, for the same thing happened to my husband who is 71. After many tests including a neurologist test and a muscle biopsy, his doctors found he had a muscle and nerve disease. The biopsy found no diagnosis from the Mayo Clinic.
I went on the internet and found PPS (post polio syndrome). I asked my husband if he had polio as a child and sure enough, he had. All the characteristics are the same as he once had and he will visit a specialist tomorrow. This might be an interesting subject to write about.
A: And so I will.
Post polio syndrome (PPS) is a condition that affects polio survivors a number of years following recovery from the initial attack of the poliomyelitis virus. The condition can only affect polio survivors, not individuals who have never had polio. The most common symptoms are a progression of muscle weakness, muscle atrophy, and muscular/general fatigue. Scoliosis is also common and may actually precede the atrophy and weakness. Some patients’ symptoms may be minor, while others may develop more severe issues.
The incidence of the condition is somewhat vague, since no survey has been performed since 1987. In a 1994-1995 survey, it was estimated there were about one million polio survivors in our country. Of that amount, 443,000 were reported to have had paralytic polio.
Diagnosis of post polio syndrome is often difficult and may be acquired entirely on clinical information, since there are no specific lab tests available, although an MRI, CT of the spinal cord, and electrophysiological studies may assist. Thus, a medical history and physician examination are often the best tools. A physician will exclude possible conditions and look for such verification as a new progression of muscle weakness or decreased endurance with or without general fatigue, atrophy or joint pain, paralytic poliomyelitis, weakness, muscle atrophy, recovery 15 or more years prior, and more.
Presently there is no effective pharmaceutical treatment that can reverse the symptoms or halt the deterioration caused by PPS, yet numerous studies have determined that exercises that do not stress the patient may go a long way to improve muscle strength, yet they may reduce the fatigue aspect. It appears most clinical trials have honed in on finding therapy procedures that are safe, help reduce symptoms and improve a patient’s quality of life. Researchers at the NIH (National Institutes of Health) have experimented with high doses of prednisone toward such a goal; however, the results were less than optimal which led them to conclude that prednisone should not be used. Other studies have found that IV immunoglobulin may work toward lowering the pain level of patients.
Other readers who would like additional information on PPS can contact the National Institute of Neurological Disorders and Stroke network BRAIN (Brain Resources and Information Network) at http://www.ninds.nih.gov, through the March of Dimes at http://ww.marchofdimes.com, or through Post-Polio Health International at http://www.post-polio.org.
