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Report targets best practices for postpolio syndrome

The difficult-to-diagnose ailment has surfaced as a harsh reminder of the polio epidemic that swept the nation in the 1950s.

By Susan J. Landers, amednews staff. June 25, 2001.

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Washington -- Patients who survived polio many years ago may now be arriving in physicians' offices complaining of new progressive muscle weakness, fatigue and pain in muscles and joints.

Postpolio syndrome is a little understood, secondary illness now confronting thousands of polio survivors and their physicians.

In a new report, the March of Dimes estimates that up to 250,000 polio survivors in the United States face the threat of new disabilities 15 to 40 years after contracting their original illness.

The disease is difficult to diagnose, in part because there are no definitive tests for the condition. As a result, the report finds that many physicians fail to recognize the illness. To correct this situation, the March of Dimes has identified best practices in diagnosis and care in a report specifically targeted to doctors.

"The causes of PPS are not thoroughly understood," said Lewis P. Rowland, MD, professor of neurology at Columbia University College of Physicians and Surgeons in New York City.

"In the initial acute polio episode, patients can lose up to 60% or 70% of their motor nerve cells," said Dr. Rowland, who also heads the March of Dimes' Steering Committee on Post-Polio Syndrome.

Surviving nerve cells attach themselves to muscle fibers that still work, and a patient's motor function is restored.

However, 15 to 40 years later, "the ability to maintain function seems to be lost," Dr. Rowland said. "But no one is certain why this happens."

One theory holds that the motor nerves that sprouted new connections years earlier to make up for other nerves killed by polio simply wear out prematurely under the added load. [...]