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: 73 relevant articles (3 outcomes, 15 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

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

Experts

1.	Borg, Kristian: 12 articles (09/2015 - 12/2002)
2.	Gonzalez, Henrik: 5 articles (01/2012 - 12/2002)
3.	Olsson, Tomas: 5 articles (01/2012 - 12/2002)
4.	Werhagen, Lars: 4 articles (09/2015 - 11/2011)
5.	Khademi, Mohsen: 3 articles (01/2012 - 12/2002)
6.	Broman, Lisbet: 2 articles (09/2015 - 12/2012)
7.	Goebel, Andreas: 2 articles (07/2014 - 05/2010)
8.	Gilhus, N E: 2 articles (01/2007 - 06/2003)
9.	Farbu, E: 2 articles (01/2007 - 06/2003)
10.	Rekand, T: 2 articles (01/2007 - 06/2003)

Drugs and Biologics

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

1.	Intravenous Immunoglobulins (IVIG)FDA Link 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. " 07/01/2008 - "For neurodegenerative diseases such as Alzheimer's disease, post-polio syndrome, pain, fibrosis, and autoimmune sleep disorders, some early promising results for the use of IVIg are emerging, but remain to be fully investigated. " 03/01/2006 - "To analyse changes in muscle strength, physical performance and quality of life during intravenous immunoglobulin (IVIg) treatment in patients with post-polio syndrome. " 05/01/2010 - "The Medline database and international trial registry databases were searched using the keywords "intravenous immunoglobulin" or "IVIG," "pain" or "chronic pain," "neuropathic pain," "CRPS," "complex regional pain syndrome" or "fibromyalgia." Evidence from RCTs suggest that IVIG is effective to reduce pain in complex regional pain syndrome (low-dose IVIG) and post-polio syndrome (high-dose IVIG), and open trials have suggested efficacy in additional pain conditions. "
2.	Immunoglobulins (Immunoglobulin)IBA 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. " 09/01/2015 - "Immunoglobulin treatment in post-polio syndrome: Identification of responders and non-responders." 01/01/2012 - "Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up."
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. " 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.	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. "
6.	CytokinesIBA 12/15/2002 - "Pro-inflammatory cytokines and motor neuron dysfunction: is there a connection in post-polio syndrome?" 01/01/2012 - "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. "
7.	RNA (Ribonucleic Acid)IBA 05/25/1995 - "Enteroviral RNA was detected in 3 of 24 patients with a clinical diagnosis of post-polio syndrome, but in none of 36 patients with stable poliomyelitis, and none of 36 patients with other neurological conditions of noninfective origin. " 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. "
8.	Pyridostigmine Bromide (Pyridostigmine)FDA LinkGeneric 08/01/1995 - "An open trial of pyridostigmine in post-poliomyelitis 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. "
9.	Immunoglobulin G (IgG)IBA 07/01/2014 - "IgG may reduce pain in a range of nociceptive and neuropathic chronic pain conditions, including diabetes mellitus, Sjögren's syndrome, fibromyalgia, complex regional pain syndrome, post-polio syndrome, and pain secondary to pathological 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. "
10.	coenzyme Q10 (CoQ10)IBA 10/01/2008 - "Thus, supplementation with coenzyme Q10 has no beneficial effect on muscle function in patients with post-polio syndrome." 10/01/2008 - "Coenzyme Q10 supplementation leads to increased muscle metabolism in patients with post-polio syndrome. " 10/01/2008 - "The aim of this study was to investigate the effect of resistance training in combination with oral supplementation with coenzyme Q10 in patients with post-polio syndrome regarding muscle strength and endurance as well as functional capacity and health-related quality of life. " 10/01/2008 - "There was no effect of coenzyme Q10 supplementation during resistance training on post-polio syndrome symptoms. " 12/01/2015 - "Coenzyme Q10 has been shown to boost muscle energy metabolism in post-polio subjects but it does not promote muscle strength, endurance or function in polio survivors with post-poliomyelitis syndrome. "

Therapies and Procedures

1.	Orthotic Devices (Orthosis) 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]." 10/01/2013 - "To evaluate the differences in gait characteristics and gait symmetry of post-polio syndrome (PPS) patients ambulating with or without shoes and between subgroups walking with different walking aids and orthoses, study the correlation of these data with personal data, illness condition, physical health, frequency of using aids and orthotics and frequency of falls, and derive recommendations for standardization of reporting these data. " 11/01/1997 - "To assess the usage of carbon fibre orthoses in assisting post-polio syndrome patients who reported advancing weakness and difficulty in maintaining their independent ambulatory status. " 11/01/1997 - "A pilot study to determine the efficiency of lightweight carbon fibre orthoses in the management of patients suffering from post-poliomyelitis syndrome."
2.	Self-Help Devices (Assistive Technology) 01/01/2014 - "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. "
3.	Resistance Training 10/01/2008 - "A total of 14 patients (8 women and 6 men) with post-polio syndrome participated in a 12-week muscular resistance training, 3 days/week. " 05/25/1995 - "Effect of strength training in patients with post-polio syndrome. " 10/01/2008 - "The aim of this study was to investigate the effect of resistance training in combination with oral supplementation with coenzyme Q10 in patients with post-polio syndrome regarding muscle strength and endurance as well as functional capacity and health-related quality of life. " 10/01/2008 - "There was no effect of coenzyme Q10 supplementation during resistance training on post-polio syndrome symptoms. "
4.	Exercise Therapy (Therapy, Exercise) 01/01/2010 - "Exercise therapy and cognitive behavioural therapy to improve fatigue, daily activity performance and quality of life in postpoliomyelitis syndrome: the protocol of the FACTS-2-PPS trial."
5.	Denervation 03/01/2004 - "The progression is accelerated in motoneuron disease, progressing more rapidly in the post-polio syndrome after prolonged denervation and extremely rapidly in ALS." 06/01/1991 - "Neurologically normal patients with suspected postpoliomyelitis syndrome: electromyographic assessment of past denervation." 01/01/1987 - "Post-poliomyelitis syndrome: evidence of ongoing denervation in symptomatic and asymptomatic patients." 06/01/1991 - "It was concluded that (1) there is a group of patients whose histories of poliomyelitis are uncertain, and (2) the lack of clear evidence for previous denervation after extensive electrodiagnostic testing is a valid means for excluding the diagnosis of postpoliomyelitis syndrome." 03/01/2002 - "Chronic denervation syndromes such as the post-polio syndrome are associated with progressive muscle weakness and fatigue after motoneuron death. "