Postpoliomyelitis Syndrome (Post-Polio Syndrome)

A syndrome characterized by new neuromuscular symptoms that occur at least 15 years after clinical stability has been attained in patients with a prior history of symptomatic poliomyelitis. Clinical features include new muscular weakness and atrophy of the limbs, bulbar innervated musculature, and muscles of respiration, combined with excessive fatigue, joint pain, and reduced stamina. The process is marked by slow progression and periods of stabilization. (From Ann NY Acad Sci 1995 May 25;753:68-80)

Also Known As:

Networked: 106 relevant articles (9 outcomes, 23 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Fatigue
2.	Pain (Aches)
3.	Neurodegenerative Diseases (Neurodegenerative Disease)
4.	Sleep Wake Disorders
5.	Fibrosis (Cirrhosis)

Experts

1.	Borg, Kristian: 13 articles (09/2015 - 12/2002)
2.	Werhagen, Lars: 5 articles (09/2015 - 07/2011)
3.	Gonzalez, Henrik: 5 articles (07/2012 - 12/2002)
4.	Olsson, Tomas: 5 articles (07/2012 - 12/2002)
5.	Fischer, Dirk: 3 articles (11/2021 - 01/2017)
6.	Gocheva, Vanya: 3 articles (11/2021 - 01/2017)
7.	Hafner, Patricia: 3 articles (11/2021 - 01/2017)
8.	Schmidt, Simone: 3 articles (11/2021 - 01/2017)
9.	Koopman, Fieke S: 3 articles (07/2017 - 01/2010)
10.	Nollet, Frans: 3 articles (07/2017 - 01/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Postpoliomyelitis Syndrome:

1.	Intravenous Immunoglobulins (IVIG)FDA Link 06/01/2006 - "We did a multicentre, randomised, double-blind, placebo-controlled study of intravenous immunoglobulin in post-polio syndrome. " 06/01/2006 - "Intravenous immunoglobulin for post-polio syndrome: a randomised controlled trial." 09/01/2015 - "To define and characterize responders and non-responders in a group of 124 patients with post-polio syndrome who received a single treatment with intravenous immunoglobulin. " 12/01/2012 - "The aim of this work is to evaluate the outcome of IVIG treatment in patients with post-polio syndrome (PPS) and to identify responders. " 01/01/2007 - "Post-polio syndrome patients treated with intravenous immunoglobulin: a double-blinded randomized controlled pilot study."
2.	Analgesics (Analgesic Drugs)IBA 12/16/2016 - "Intrathecal Analgesic Drug Delivery is Effective for Analgesia in a Patient with Post-Poliomyelitis Syndrome: A Case Report."
3.	AntibodiesIBA 06/01/2003 - "We studied the relationship between post-polio syndrome (PPS) and GM1 antibodies, since such antibodies have been associated with PPS and motor neuron disorders. " 05/25/1995 - "Detection of poliovirus antibodies and poliovirus genome in patients with the post-polio syndrome." 06/01/2003 - "GM1 antibodies in post-polio syndrome and previous paralytic polio." 05/25/1995 - "Antiganglioside antibodies in patients with acute polio and post-polio syndrome." 07/01/1994 - "Twenty-one patients with strictly defined postpoliomyelitis syndrome: no poliovirus-specific IgM antibodies in the cerebrospinal fluid."
4.	Immunoglobulin M (IgM)IBA 07/01/1994 - "Twenty-one patients with strictly defined postpoliomyelitis syndrome: no poliovirus-specific IgM antibodies in the cerebrospinal fluid." 09/12/1991 - "In quantitative studies there was evidence of increased intrathecal synthesis of IgM antibodies to poliovirus only among the patients with the post-polio syndrome; there was no increased synthesis of IgM to measles, mumps, herpes simplex, or varicella zoster viruses. " 10/01/2023 - "In contrast, based on Class I evidence, IVIG is not recommended for inclusion body myositis, post-polio syndrome, IgM paraproteinemic neuropathy and small fiber neuropathy that is idiopathic or associated with tri-sulfated heparin disaccharide or fibroblast growth factor receptor-3 autoantibodies. " 05/25/1995 - "To understand the mechanism of post-poliomyelitis muscular atrophy (PPMA) and the post-polio syndrome (PPS) in general, we performed the following studies: (1) histopathology in spinal cord sections from patients who died 9 days to 44 years after acute paralytic poliomyelitis; (2) enzyme histochemistry, immunocytochemistry (for lymphocyte subsets, MHC antigens and N-CAM) and polymerase chain reaction (PCR) for poliovirus RNA in the muscle biopsies from symptomatic or asymptomatic muscles of post-polio patients; (3) determination of lymphocyte subsets and circulating IgG or IgM antibodies against GM1 and poliovirus; (4) virological studies in the spinal fluid for oligoclonal bands and search for poliovirus genome with PCR; (5) electrophysiological studies including single fiber EMG, fiber density and macro-EMG; and (6) [31P] exercise MRS spectroscopy on previously affected muscles to search for a metabolic correlate of fatigue. "
5.	EnzymesIBA 10/01/2001 - "A study of the clinical features, physical activity, muscle enzyme, electromyography and histopathological alternations of muscles in patients with post-polio syndrome (PPS). " 10/01/2001 - "Varied clinical patterns, physical activities, muscle enzymes, electromyographic and histologic findings in patients with post-polio syndrome in Taiwan." 05/25/1995 - "To understand the mechanism of post-poliomyelitis muscular atrophy (PPMA) and the post-polio syndrome (PPS) in general, we performed the following studies: (1) histopathology in spinal cord sections from patients who died 9 days to 44 years after acute paralytic poliomyelitis; (2) enzyme histochemistry, immunocytochemistry (for lymphocyte subsets, MHC antigens and N-CAM) and polymerase chain reaction (PCR) for poliovirus RNA in the muscle biopsies from symptomatic or asymptomatic muscles of post-polio patients; (3) determination of lymphocyte subsets and circulating IgG or IgM antibodies against GM1 and poliovirus; (4) virological studies in the spinal fluid for oligoclonal bands and search for poliovirus genome with PCR; (5) electrophysiological studies including single fiber EMG, fiber density and macro-EMG; and (6) [31P] exercise MRS spectroscopy on previously affected muscles to search for a metabolic correlate of fatigue. "
6.	CitrullineIBA 11/01/2021 - "This single-centered, randomized, double-blind, placebo-controlled study reports the results of L-Citrulline treatment for 24 weeks in patients with post-polio syndrome (PPS). " 11/01/2021 - "Treatment with L-Citrulline in patients with post-polio syndrome: A single center, randomized, double blind, placebo-controlled trial." 01/01/2017 - "Treatment with L-citrulline in patients with post-polio syndrome: study protocol for a single-center, randomised, placebo-controlled, double-blind trial."
7.	CytokinesIBA 12/15/2002 - "Pro-inflammatory cytokines and motor neuron dysfunction: is there a connection in post-polio syndrome?" 11/01/2011 - "An increase in cytokine in the cerebrospinal fluid suggests that inflammation is pathophysiologically important in post-polio syndrome. " 07/09/2012 - "Expression of inflammatory cytokines in cerebrospinal fluid (CSF) has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS). " 12/15/2002 - "In order to study the role of a possible inflammatory reaction in the post-polio syndrome (PPS) four key cytokines were determined by means of mRNA expression in mononuclear cells from cerebrospinal fluid (CSF) and peripheral blood of 13 patients. " 07/09/2012 - "Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up."
8.	Oligoclonal BandsIBA 09/12/1991 - "Oligoclonal IgM bands specific to poliovirus were detected in the cerebrospinal fluid of 21 of the 36 patients with the post-polio syndrome (58 percent) but in none of the control group (P less than 0.0001). " 08/01/1990 - "Oligoclonal bands in the cerebrospinal fluid of post-poliomyelitis muscular atrophy." 05/25/1995 - "To understand the mechanism of post-poliomyelitis muscular atrophy (PPMA) and the post-polio syndrome (PPS) in general, we performed the following studies: (1) histopathology in spinal cord sections from patients who died 9 days to 44 years after acute paralytic poliomyelitis; (2) enzyme histochemistry, immunocytochemistry (for lymphocyte subsets, MHC antigens and N-CAM) and polymerase chain reaction (PCR) for poliovirus RNA in the muscle biopsies from symptomatic or asymptomatic muscles of post-polio patients; (3) determination of lymphocyte subsets and circulating IgG or IgM antibodies against GM1 and poliovirus; (4) virological studies in the spinal fluid for oligoclonal bands and search for poliovirus genome with PCR; (5) electrophysiological studies including single fiber EMG, fiber density and macro-EMG; and (6) [31P] exercise MRS spectroscopy on previously affected muscles to search for a metabolic correlate of fatigue. "
9.	Biomarkers (Surrogate Marker)IBA 01/01/2021 - "CMC has potential in future clinical trials as a biomarker of altered function in motor networks in post-polio syndrome, SMA, and other related conditions." 06/01/2019 - "Motor Unit Number Index (MUNIX) as a biomarker of motor unit loss in post-polio syndrome versus needle EMG." 01/30/2009 - "Identification of novel candidate protein biomarkers for the post-polio syndrome - implications for diagnosis, neurodegeneration and neuroinflammation."
10.	Pyridostigmine Bromide (Pyridostigmine)FDA LinkGeneric 08/01/1995 - "An open trial of pyridostigmine in post-poliomyelitis syndrome." 05/01/2016 - "Pyridostigmine: Postpoliomyelitis Syndrome." 12/01/2003 - "Pyridostigmine in the prescribed dose did not reduce fatigue in subjects with postpoliomyelitis syndrome. " 12/01/2003 - "To investigate the effect of pyridostigmine on fatigue, physical performance, and muscle function in subjects with postpoliomyelitis syndrome. "

Therapies and Procedures

1.	Therapeutics 03/01/2018 - "Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome. " 07/07/2017 - "Thus, the lack of efficacy of cognitive behavioural therapy in post-polio syndrome cannot be attributed to unique cognitive characteristics of this population." 07/07/2017 - "Patients with post-polio syndrome (n = 21) and facioscapulohumeral dystrophy (n = 24) allocated to a cognitive behavioural therapy intervention in 2 identical trials. " 02/10/2016 - "Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy." 07/07/2017 - "Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. "
2.	Transcranial Direct Current Stimulation 01/01/2013 - "Anodal tDCS over the pre-motor areas for fifteen days improved sleep and fatigue symptoms in patients with post-polio syndrome. " 01/01/2013 - "Here, we assessed whether transcranial direct current stimulation (tDCS) improves sleep and fatigue symptoms in patients with post-polio syndrome. " 01/01/2013 - "Transcranial direct current stimulation (tDCS) for sleep disturbances and fatigue in patients with post-polio syndrome." 10/15/2023 - "Studies employing tDCS for fatigue management across neurological conditions is as follows: Multiple sclerosis (MS) (n = 28, 66%), stroke (n = 5, 12%), Parkinson's disease (PD) (n = 4, 10%), post-polio syndrome (PPS) (n = 2, 5%), traumatic brain injury (TBI) (n = 2, 5%), and amyotrophic lateral sclerosis (n = 1, 2%). "
3.	Self-Help Devices (Assistive Technology) 01/24/2014 - "Wearable monitoring devices for assistive technology: case studies in post-polio syndrome." 05/01/2012 - "To explore the relationship between level of happiness in people with post-polio syndrome (PPS) and assistive technology (AT) by taking into account confounding factors such as age, gender and house composition. " 11/01/2006 - "Patient education, health promotion, and energy conservation strategies that included walking with a properly fitting assistive device reduced perceived fatigue and improved posture and function in an individual with post-polio syndrome." 11/01/2006 - "This case report describes effective intervention strategies that included gait training with the use of an acceptable, assistive device for the management of impaired posture and fatigue associated with post-polio syndrome. "
4.	Analgesia 05/01/2008 - "Demographic data, physical status (ASA), onset of the disease, body part affected, diagnosis of post-poliomyelitis syndrome, surgeries and type anesthesia used, postoperative analgesia, intra- and postoperative complications, outpatient follow-up, and development of neurological changes were evaluated. " 12/16/2016 - "Intrathecal Analgesic Drug Delivery is Effective for Analgesia in a Patient with Post-Poliomyelitis Syndrome: A Case Report."
5.	Foot Orthoses 09/01/1991 - "We thought that the disuse and overuse of the lower extremities played a part in the onset of post-polio syndrome and that the rehabilitation including the low-load repetitive muscle strengthening exercises and gait training with a supracondylar knee-ankle-foot orthosis was effective against her disability." 09/01/1991 - "[Supracondylar knee-ankle-foot orthosis for post-polio syndrome]."