Post-polio syndrome

Post-polio syndrome (PPS, or post-poliomyelitis syndrome or post-polio sequelae) is a condition that affects polio survivors years after their recovery from an initial acute attack of the poliovirus. It is characterized by new and progressive muscular weakness, pain, and fatigue that becomes apparent many years after the occurrence of acute paralytic or non-paralytic polio.

Signs and symptoms
These include the following:
 * Fatigue (both general and muscular)
 * Muscle weakness
 * Muscle pain
 * Gait disturbance
 * Respiratory problems
 * Swallowing problems (dysphagia)
 * Autonomic dysfunction
 * Sleep apnea
 * Flat-back syndrome

Incidence and prevalence
The exact incidence and prevalence of postpolio syndrome (PPS) is unknown and statistics vary. Medscape reports the incidence in previous acute polio patients ranges from approximately 22-68%. The NIH estimates that the condition affects 25 to 40 percent of polio survivors. In 1992, a study of former poliomyelitis patients from Allegheny County, Pennsylvania estimates 28.5% of all paralytic polio cases develop PPS. Suggestions have been made that 100% of polio survivors, if tracked for a long period, can develop some symptoms of PPS.

ME/CFS

 * In 1998 polio expert Richard Bruno, along with colleagues, reviewed the clinical findings in PPS and chronic fatigue syndrome (CFS). They found significant parallels which suggested a possible common pathophysiology.
 * In 2014 a Swedish clinician, using Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), compared the quality of life in 124 patients with PPS and 100 patients with ME/CFS. Results indicated that both groups have lower quality of life than Swedish controls, and that ME/CFS patients had a lower quality of life compared with PPS patients.
 * A study in 2019, using the self-reporting questionnaires, DePaul Symptom Questionnaire 2 (DSQ-2) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), found that participants with ME/CFS were more functionally impaired across symptoms than those with PPS. Additionally, the study found that the three domains that most commonly differentiated ME/CFS from PPS were neurocognitive, post-exertional malaise, and neuroendocrine.

Research studies

 * 1998, Parallels between post-polio fatigue and chronic fatigue syndrome: a common pathophysiology? - (Abstract)
 * 2014, Comparison of quality of life in patients with post-polio syndrome and myalgic encephalomyelitis/chronic fatigue syndrome with Swedish norm - (Abstract)
 * 2019, Differentiating post-polio syndrome from myalgic encephalomyelitis and chronic fatigue syndrome - (Abstract)

Learn more

 * NIH Post-Polio Syndrome information Sheet