Post-Polio Syndrome

Post-polio syndrome is a clinical condition affecting people who have recovered from acute paralytic poliomyelitis and present with new neuromuscular symptoms typically 15 to 40 years after the original infection. It results from progressive degeneration of enlarged motor units that compensated for the initial loss of motor neurons.

Patients describe new or progressive muscle weakness in previously affected or apparently spared muscles, profound fatigue, muscle and joint pain, atrophy, cold intolerance, sleep disturbance, swallowing and respiratory difficulties. The diagnosis requires a confirmed history of paralytic polio, a period of stable recovery and exclusion of alternative causes of new neuromuscular symptoms.

Management is primarily supportive and multidisciplinary. Key principles include energy conservation, pacing, low-intensity non-fatiguing exercise, weight management, appropriate orthoses and assistive devices, treatment of sleep apnea and noninvasive ventilation when indicated, and psychosocial support. Pharmacotherapy targets symptomatic pain and sleep disturbance.