Lincolnshire Post-Polio Library [Post-Polio Syndrome: Pathophysiology and Clinical Management]

Lincolnshire Post-Polio Library - A Service of The Lincolnshire Post-Polio Network

Post-Polio Syndrome: Pathophysiology and Clinical Management

Anne Carrington Gawne and Lauro S. Halstead
The Post-Polio Program, National Rehabilitation Hospital, 102 Irving St., NW, Washington, DC 20010

Critical Reviews in Physical and Rehabilitation Medicine, 7(2):147-188 (1995)
0896-2960/95/$5.00
© 1995 by Begell House, Inc.

Lincolnshire Post-Polio Library copy by kind permission of Dr. Gawne.

ABSTRACT: Post-polio syndrome (PPS) is a progressive neuromuscular syndrome characterized by symptoms of weakness, fatigue, pain in muscles and joints, and breathing and swallowing difficulties. Survivors of poliomyelitis experience it many years after their initial infection. Although the etiology for these symptoms is unclear, it may be due to motor unit dysfunction manifested by deterioration of the peripheral axons and neuromuscular junction, probably as result of overwork. An estimated 60% of the over 640,000 paralytic polio survivors in the U.S. may suffer from the late effects of polio. Their physical and functional rehabilitation care presents a challenge for practitioners in all disciplines. To evaluate these symptoms, a comprehensive assessment must be done, as frequently PPS is a diagnosis of exclusion. Care of the patient with PPS is best carried out by an interdisciplinary team of rehabilitation specialists. This article reviews the epidemiology, pathophysiology, characteristics, assessment, and rehabilitation care of the patient with PPS.

KEY WORDS: poliomyelitis, post-polio syndrome, weakness, fatigue, exercise, pain therapy, respiratory complications.

CONTENTS

I.	INTRODUCTION.
II.	HISTORICAL BACKGROUND.
III.	EPIDEMIOLOGY.
IV.	PATHOPHYSIOLOGY IN ACUTE POLIO.
V.	PATHOLOGY IN CHRONIC POLIOMYELITIS.
VI.	CLARIFICATION OF NOMENCLATURE.
VII.	CLINICAL FEATURES OF POSTPOLIO SYNDROME.
VIII.	ELECTRODIAGNOSTIC FEATURES.
IX.	MORPHOLOGIC FEATURES.
X.	EVALUATION OF THE POST-POLIO PATIENT.
XI.	DIFFERENTIAL DIAGNOSIS AND REHABILITATION MANAGEMENT.
XII.	PROGNOSIS.
XIII.	CONCLUSION.
	REFERENCES.

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This document comprises fifteen sections or subdocuments. Permission for printing copies is granted only on the basis that ALL sections are printed in their entirety and kept together as a single document. It is also available as a single 226K document, <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/gawne/ppspandcm.html>

Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/library/gawne/ppspandcm-s00.html>
Created: 5th June 2000
Last modification: 5th June 2000