Is post-polio syndrome as dangerous as polio?

Post-polio syndrome refers to a group of latent polio symptoms that appear decades — about 30 to 40 years — after the first onset of polio. People who contracted polio in childhood may have post-polio syndrome later in life. So how to detect and treat this syndrome? Follow SignsSymptomsList to follow the article below to get the most useful information.

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• 1. What are the symptoms of Post-polio Syndrome?
• 2. What is the cause?
• 3. What are the risk factors for Post-Polypolio Syndrome?
• 4. What are complications?
• 5. How is it diagnosed?
• 6. How to treat Post-polio syndrome?

1. What are the symptoms of Post-polio Syndrome?

Common signs and symptoms are:

• Weakness and pain in muscles and joints gradually increase
• Fatigue and exhaustion from light activities
• Amyotrophic lateral sclerosis
• Breathing and swallowing problems
• Sleep-related breathing disturbances, such as sleep apnea
• Reduced cold tolerance

In most cases, post-polio syndrome develops slowly, with many symptoms appearing slowly, followed by periods of stabilization.

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2. What is the cause?

There are a few theories for the cause of post-polio syndrome, but nothing is certain.

When the polio virus infects the body, it affects motor neurons. Each neuron has three basic parts:

• Cell body
• Axon
• dendrites

Infection with the polio virus often damages or destroys motor neurons. To compensate for the lack of neurons, the remaining neurons give rise to new branches and hypertrophy of muscle fibers.

This promotes the recovery of muscle function, but also requires the neuronal body to grow new nerve branches. After many years, neurons are exhausted, leading to weakening of new nerve branches.

3. What are the risk factors for Post-Polypolio Syndrome?

• Severity of primary polio . The more severe the initial infection, the higher the risk of post-polio syndrome.
• Age of onset of polio . If you have polio as a teenager or an adult, your risk of post-polio syndrome is higher.
• Recovery level . The better the recovery from acute polio, the greater the risk of post-polio syndrome. Probably because the better the recovery, the more pressure on the motor neurons.
• Excessive activity . Exercising to the point of exhaustion overloads neurons and increases the risk of post-polio syndrome.

4. What are complications?

Post-polio syndrome is rarely life-threatening. But severe muscle weakness can cause the following complications:

• Fall down . Weak leg muscles make you lose balance and fall easily. May lead to fractures, such as femoral neck fractures in the elderly.
• Malnutrition, dehydration and pneumonia . Cerebral palsy causes difficulty chewing and swallowing. Leads to malnutrition and dehydration, as well as aspiration of food into the lungs causing pneumonia.
• Chronic respiratory failure . Weakness in the diaphragm and chest muscles makes it difficult to take deep breaths and coughs, causing fluid and mucus to build up in the lungs. Obesity, smoking, scoliosis, anesthesia, and prolonged immobilization can worsen shortness of breath, leading to hypoxemia (acute respiratory failure). Ventilation therapy may be needed to assist with breathing.
• Osteoporosis . Long-term inactivity or immobility often causes loss of bone density and osteoporosis in both men and women.

5. How is it diagnosed?

There is no test to diagnose post-polio syndrome. Diagnosis is based on history and physical examination and exclusion of other disorders.

Signs of post-polio syndrome

• History of polio . Previous polio tests and diagnoses.
• The recovery period is long . People recovering from polio for the first time often have no symptoms for many years. Late symptoms usually appear after at least 15 years.
• Start slowly . Later-onset muscle weakness is usually in muscles that have been damaged by previous paralysis. Usually only noticed when it has affected daily work. Muscle weakness is milder in the morning and heavier in the afternoon, making normally easy tasks difficult.

Because post-polio symptoms are similar to other disorders, causes such as arthritis, fibromyalgia, chronic fatigue syndrome, and scoliosis must be ruled out.

Tests to rule out other diseases

Because there is no diagnostic test, testing is primarily done to rule out other conditions, including:

• Electromyography (EMG) . Electromyography measures the electrical signal in the muscle by inserting an electrode into the muscle to be examined. Includes electromyography at rest and during contraction. In addition, electrodes can also be glued to the skin of the nerve to be examined. This test helps identify and rule out conditions such as neuropathy and myopathy.
• School image . An MRI or CT scan helps to look at images of the brain and spinal cord. Exclude spinal cord diseases, such as spondylolisthesis or spinal stenosis.
• Muscle biopsies . Helps rule out other causes of muscle weakness.
• Blood test . usually have normal blood tests. Abnormal tests help rule out other conditions.

A promising noninvasive test for assessing the severity of post-polio syndrome and monitoring disease progression is muscle ultrasound. However, more research is needed.

6. How to treat Post-polio syndrome?

There is no single treatment for all symptoms of post-polio syndrome. The goals of treatment are to control your symptoms and make you as comfortable and as dependent as possible:

• Energy conservation . Work out at a pace and rest often to reduce fatigue. Assistive devices, such as canes, walkers, wheelchairs, can help conserve energy. Installing bathroom rails or a high toilet seat can also help.
• Physiotherapy . Exercises that strengthen muscles without causing muscle fatigue, like swimming or water aerobics. Exercise to maintain fitness is very important. But avoid overtraining or overtraining.
• Speech therapy . Exercises to relieve symptoms of dysphagia, strengthen the voice.
• Treatment of sleep apnea . Change your sleeping habits, such as avoiding sleeping on your back or using a device to clear your airways while you sleep.
• Drugs . Pain relievers — such as aspirin, acetaminophen, and ibuprofen — can relieve muscle and joint pain.

Other treatments include the anticonvulsant drug gabapentin, commonly used to treat nerve pain. Opioid pain relievers are not usually used because of the long-term risk.

Life style

• Reduce activities that cause pain or fatigue . Moderately active, do not over-exercise.
• Keep warm . Low temperatures cause muscles to fatigue more quickly. Keep the indoor temperature comfortable and stay warm when going out.
• Avoid falling . Avoid messy floors, wear good shoes, avoid walking on slippery surfaces.
• Maintain a healthy lifestyle . Eat a balanced diet, don't smoke, reduce caffeine use to stay in shape, breathe easier and sleep better.
• Lung protection . Monitor for signs of respiratory infections for prompt treatment. Stop smoking, get flu and pneumococcal shots.

Polio can be fatal, and thanks to a vaccine, today the number of infections is very small. However, people who had polio as children are at increased risk for post-polio syndrome. Post-polio syndrome is rarely fatal but can result in complications that affect life function. If you have symptoms of muscle weakness and increasing fatigue, contact your doctor for timely examination and treatment.

Dr. PHAN VAN GIAO