Abstract
Purpose of Review
Post-polio syndrome (PPS) is commonly experienced by geriatric patients with a history of acute paralytic poliomyelitis. The goal of this review is to educate clinicians about the clinical presentation and diagnostic criteria for PPS as well as explore established and experimental treatment options.
Recent Findings
On review of the literature, there is no new research identifying effective interventions for PPS.
Summary
The paucity of recent studies is not surprising since polio patients are diminishing in number. There is some hope that interventions for other similar conditions may cross over and show some utility for PPS. In lieu of further treatment options, clinicians should be comfortable educating their patients on the course of the disease and providing supportive management such as physical therapy and bracing.
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References
Papers of particular interest, published recently, have been highlighted as: •of importance
Halstead LS. Assessment and differential diagnosis for post-polio syndrome. Orthopedics. 1991;14(11):1209–17.
Farbu E, Gilhus NE, Barnes MP, Borg K, de Visser M, Driessen A, et al. EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force. Eur J Neurol. 2006;13(8):795–801.
Tracking progress towards global polio eradication, 2010–2011. Weekly epidemiological record: Relevé épidémiologique hebdomadaire. Geneva: World Health Organization. 2012 April;87:153–160. Available from: http://www.who.int/wer/2012/wer8716.pdf
Becker LC. Polio survivors in the US 1915–2000 age distribution data [Internet]. Post-polio health international [cited 2016 Oct 1]. Available from: http://www.post-polio.org/PoliosurvivorsintheUS1915-2000.pdf
Nair KS. Muscle protein turnover: methodological issues and the effect of aging. J Gerontol A Biol Sci Med Sci. 1995;50 Spec No:107–12.
Schanke AK, Stanghelle JK. Fatigue in polio survivors. Spinal Cord. 2001;39(5):243–51.
• Koopman FS, Beelen A, Gilhus NE, de Visser M, Nollet F. Treatment for postpolio syndrome. Cochrane Database Syst Rev. 2015;5:CD007818. Updated assessment of research for treatment of PPS
Gonzalez H, Khademi M, Borg K, Olsson T. Intravenous immunoglobulin treatment of the post-polio syndrome: sustained effects on quality of life variables and cytokine expression after one year follow up. J Neuroinflammation. 2012;9:167.
Gonzalez H, Sunnerhagen KS, Sjoberg I, Kaponides G, Olsson T, Borg K. Intravenous immunoglobulin for post-polio syndrome: a randomised controlled trial. Lancet Neurol. 2006;5(6):493–500.
Kaponides G, Gonzalez H, Olsson T, Borg K. Effect of intravenous immunoglobulin in patients with post-polio syndrome—an uncontrolled pilot study. J Rehabil Med. 2006;38(2):138–40.
Farbu E, Rekand T, Vik-Mo E, Lygren H, Gilhus NE, Aarli JA. Post-polio syndrome patients treated with intravenous immunoglobulin: a double-blinded randomized controlled pilot study. Eur J Neurol. 2007;14(1):60–5.
Ostlund G, Broman L, Werhagen L, Borg K. IVIG treatment in post-polio patients: evaluation of responders. J Neurol. 2012;259(12):2571–8.
Bertolasi L, Acler M, dall’ora E, Gajofatto A, Frasson E, Tocco P, et al. Risk factors for post-polio syndrome among an Italian population: a case-control study. Neurol Sci. 2012;33(6):1271–5.
• Huang YH, Chen HC, Huang KW, Chen PC, Hu CJ, Tsai CP, et al. Intravenous immunoglobulin for postpolio syndrome: a systematic review and meta-analysis. BMC Neurol. 2015;15:39. Determines that IVIg confers no clear benefit in PPS
Chan KM, Strohschein FJ, Rydz D, Allidina A, Shuaib A, Westbury CF. Randomized controlled trial of modafinil for the treatment of fatigue in postpolio patients. Muscle Nerve. 2006;33(1):138–41.
Vasconcelos OM, Prokhorenko OA, Salajegheh MK, Kelley KF, Livornese K, Olsen CH, et al. Modafinil for treatment of fatigue in post-polio syndrome: a randomized controlled trial. Neurology. 2007;68(20):1680–6.
Horemans HL, Nollet F, Beelen A, Drost G, Stegeman DF, Zwarts MJ, et al. Pyridostigmine in postpolio syndrome: no decline in fatigue and limited functional improvement. J Neurol Neurosurg Psychiatry. 2003;74(12):1655–61.
On AY, Oncu J, Uludag B, Ertekin C. Effects of lamotrigine on the symptoms and life qualities of patients with post polio syndrome: a randomized, controlled study. NeuroRehabilitation. 2005;20(4):245–51.
Stein DP, Dambrosia JM, Dalakas MC. A double-blind, placebo-controlled trial of amantadine for the treatment of fatigue in patients with the post-polio syndrome. Ann N Y Acad Sci. 1995;753:296–302.
Peel MM, Cooke M, Lewis-Peel HJ, Lea RA, Moyle W. A randomized controlled trial of coenzyme Q10 for fatigue in the late-onset sequelae of poliomyelitis. Complement Ther Med. 2015;23(6):789–93.
Dinsmore S, Dambrosia J, Dalakas MC. A double-blind, placebo-controlled trial of high-dose prednisone for the treatment of post-poliomyelitis syndrome. Ann N Y Acad Sci. 1995;753:303–13.
Acler M, Bocci T, Valenti D, Turri M, Priori A, Bertolasi L. Transcranial direct current stimulation (tDCS) for sleep disturbances and fatigue in patients with post-polio syndrome. Restor Neurol Neurosci. 2013;31(5):661–8.
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Lam, NY., McNalley, T.E. Post-Polio Syndrome, Implications for Geriatric Care. Curr Geri Rep 6, 20–25 (2017). https://doi.org/10.1007/s13670-017-0194-0
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DOI: https://doi.org/10.1007/s13670-017-0194-0