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Post-Polio Syndrome
Lauro S. Halstead, M.D.
Director, Post-Polio ProgramNational Rehabilitation Hospital
Washington, D.C.February 24, 2005
A. A Brief History of Polio
B. What is PPS, Anyway?
C. Do We Know the Cause of PPS?
D. How Do You Diagnose PPS?
E. How in the World Do You Treat It?
F. Is There/Should There Be Any Outreach?
Post-Polio Syndrome
Outline
A. Acute Paralytic Polio
1. Virus
2. Contaminated water/food
3. Affinity for motor (muscle) nerves
4. Kills/injures motor nerves
5. Results in weakness/paralysis
Post-Polio Syndrome
A. Acute Paralytic Polio-2
• Sporadic vs. epidemic disease• Ancient Egypt• 1916 – NYC: First major U.S. epidemic• 1920s – 1950s: Ever larger epidemics• 1952 - > 50,000 persons, mostly children
Post-Polio Syndrome
A. Acute Paralytic Polio-3
• Miracle of the vaccines• 1955 – Salk (killed, injection)
• 1961 – Sabin (weakened, oral)
• 1972 - Last case in U.S.
• 1991 - Last case in Western Hemisphere
• 2004 - < 1000 cases worldwide
Post-Polio Syndrome
B. What is PPS?
1. A neurological condition
2. New symptoms many years after
acute polio - typically 30-50 yrs.
3. New symptoms appear after a period of neurological stability
4. Major sxs- New weakness, loss of function, intense fatigue, pain in muscles/joints
Post-Polio Syndrome
C. What is the Cause of PPS?
1. Basically, tired/overworked motor nerves
leading to new weakness/fatigue/pain
2. Maybe immunologic component
Post-Polio Syndrome
D. Diagnosis
• 5 Criteria• History of acute polio• Period of recovery• Period of stability• Onset of new weakness (and other
symptoms)• Exclude other causes of new symptoms
Post-Polio Syndrome
F. Treatment
1. Rehabilitation – often ‘low tech’• Change in lifestyle• Energy conservation• “Bracing and pacing” • Exercise normal or strong muscles
2. Medications• NGF, Stem cells, Immunoglobulins
Post-Polio Syndrome