Poliomyelitis and Post-Polio Syndrome

Question 1

Polio Pathophysiology

Answer 1

caused by poliovirus which is able to cross the blood brain barrier
attacks the anterior horn cells in the spinal cord
usually preceded by flu or GTI

Question 2

Polio Muscle recovery mechanism

Answer 2

recovered neurons develop terminal axonal sprouts which re-innervate orphaned muscle fibres
results in the formation of giant motor units
hypertrophy of innervated muscles results in increased functional ability
body learns to recruit new, giant motor units

Question 3

Post-Polio Syndrome

Answer 3

disorder of the nervous system that appears 15 years after contracted polio virus

Question 4

PPS Aetiology

Answer 4

new symptom onset due to degenerative changes in the motor units
loss of terminal axonal sprouts
triggered by muscle overuse and effects of normal ageing process - degeneration of the motor units

Question 5

PPS Symptoms

Answer 5

insidious onset, precipitated by minor accident, period of bed rest, weight gain or worsening co-morbidities

• new progressive muscle weakness
• severe fatigue
• muscle and joint pain
• may develop difficulty swallowing and breathing

Question 6

PPS Clinical Features

Answer 6

fatigue 
new muscle weakness
pain 
postural abnormalitis 
ADL difficulties 
sleep impairments 
increased headaches 
respiratory insufficiency 
speech impairments 
dysphagia 
cold sensitivity

Question 7

Late effects of neurological disability

Answer 7

disuse weakness/atrophy 
deconditioning 
fatigue 
resultant weight gain 
postural deformities 
joint pain and damage from altered biomechanics 
increased dependency on carers
greater impact of normal ageing changes