Causes and symptoms of PPS
- Home
- Causes and symptoms of PPS
Causes and symptoms of PPS
If you have had polio or know someone who has, you may have questions about post-polio syndrome. Studies show that 64% of people who have had polio can, decades later, develop post-polio syndrome.
This page is intended for those who have had polio and their families, to answer the many questions they may have, as well as for the general public seeking basic information.
If you need more information, please contact the Communications Coordinator at comm@polioquebec.org. She will be happy to help in any way she can. We also invite you to like our page Facebook.
.
However, this extra effort over many years causes the exhaustion of the neuromuscular system. Over time, the premature aging and exhaustion of the motor neuron caused by the excessive demand for effort and energy causes the new growth to detach. The muscles lose their innervation (nerve supply) and gradually weaken. This process of degeneration can also produce deficiencies in nerve transmission at the neuromuscular junction (communication difficulties between the
muscle) which in turn can cause muscle fatigue. It is therefore not uncommon for people who have recovered from polio to gradually experience new difficulties with their legs, arms, breathing or energy after several years of complete independence.
Symptoms
Most common symptoms
Many symptoms can accompany post-polio syndrome (PPS). Although none of them can, in itself, be a definite diagnosis of PPS, the most common symptoms are:
Fatigue intense;
New painmuscular and articular;
Reduced stamina;
Breathing difficultiesincreased shortness of breath, increased respiratory infections;
Sleep disorders
Feeling of cold when others are hot, sometimes accompanied by burning and tingling sensationt;
Lifestyle changes (need for braces or ventilator);
Stressperiod ofanxiety and depression;
Dysphagia (difficulty in swallowing, blockage felt at the time of feeding).
The new weakness
New weakness, which is one of the most recurrent symptoms of PPS, occurs, with or without muscle loss, in approximately 20-40% of patients who have suffered from polio. This increased weakness can cause instability in the joints resulting in various deformities and sometimes causing an unbalanced gait.
Fatigue
Fatigue, the most obvious manifestation of PPS, presents itself in two ways: fatigue general and fatigue localized muscular. Many patients suffer from immediate total exhaustion following brief physical activity, known as "the polio wall. Muscle fatigue is a gradual loss of muscle strength during continuous activity. This fatigue disappears with rest.
Symptoms related to fatigue are: increased need for sleep, concentration problems, reduced stamina which leads to a change in lifestyle. In addition, people with a respiratory problem may experience a variety of other symptoms such as: increased shortness of breath, sleep problems, confusion, difficulty concentrating, etc.
These different types of symptoms can be grouped as follows:
Generals: Weakness and/or increased fatigue, decreased endurance for daily activities, lifestyle changes (need for braces or ventilator), imbalance, excessive weight gain, periods of anxiety and depression (caused by decreased physical stamina).
Neuromuscular : Increased pain and deformation of joints, muscle pain, muscle contractions, new muscle weakness, increased fractures (caused by weakness).
Respiratory : Increased shortness of breath, increased respiratory infections, language difficulties, sleep disturbances, confusion especially upon awakening, difficulty concentrating.
The new pain
The new pain is the main symptom in some patients, especially in the muscles and joints. This pain is related to physical activity. Another pain, the deep burning of the bone and muscle, is not necessarily related to a particular activity; however, it is the most difficult to treat.
Keep in mind
PPS is not necessarily permanent; another period of stability may be experienced.
Muscle non-use or under-use can resemble the symptoms of PPS. In fact, inactivity can cause a reduction in muscle strength, as well as a loss of endurance.
The loss of neuromotor function as a result of normal aging can also make the situation worse.
More frequent diseases
Some diseases occur more frequently in people who have had polio than in the general population:
Sleep apnea (breathing problems during sleep)
It can cause fatigue during the day, headaches in the morning, nightmares, snoring, difficulty concentrating and irritability.
It can be diagnosed in a sleep clinic and treated relatively easily.
Fibromyalgia
It can cause chronic, widespread pain throughout the body.
It can be treated with certain medications, aerobic exercise, etc.
Osteoporosis (loss of bone mass)
It increases the risk of bone fractures.
It can be treated with several medications.
Any treatment for these disorders associated with polio can help relieve the symptoms experienced.
Psychological impact
Finally, the psychological impact of PPS on the individual should not be ignored. PPS can also cause introversion, isolation, anxiety and frustration in those affected since :
Symptoms arise unexpectedly;
The cause is often unknown;
The person has to face ignorance and misunderstanding of the problem in the medical and paramedical world (erroneous diagnoses, denial of the doctor in front of the expressed concerns,...);
It is sometimes difficult to face reality with new limits.
Diagnostics
It is difficult to diagnose PPS because it is a syndrome of exclusion (the physician must eliminate other factors), few physicians are aware of its existence, and many of the symptoms may be mistaken by the patient for those of normal aging.
Diagnosis of PPS requires a patient history as well as a physical examination. The physician can check the muscle strength and amount of movement in each joint, and electromyography can check for prior loss of motor neurons (macro EMG).
The PPS Task Force led by Dr. Cashman, developed the diagnostic criteria for PPS in 1997. PPS is diagnosed when there is:
A credible medical history of acute polio;
A period of functional stability following the original polio condition (regardless of degree);
A recent functional change (within the last few months);
An electromyogram confirming a new degeneration.
Treatment and prevention
To date, there is no cure for PPS, so we must try to slow the process and relieve the symptoms.
Stay positive
Change your lifestyle
Restto avoid a marked decrease in your abilities. Avoid stress. Use means and tools to avoid fatigue and pain.
Stay in shape(without abusing your exercises; favour the axiom: "spare to preserve").
Set realistic goals. Respect your body.
Find out about medicationsthat can help you (e.g., to relieve pain). Be aware of the side effects related to your situation (e.g. anesthesia)
Use of technical aids(such as canes, crutches, orthotics, wheelchairs or other devices that can make your life easier).
Sleep well. Eat well.
Avoid being overweight.
Keep in mind
Among people who have had polio, those who over-stimulate their weakened muscles and do not rest when they experience muscle fatigue are more likely than others to experience a marked decrease in their abilities, i.e., a greater increase in fatigue, weakness and persistent pain.
To help themselves, polio survivors need to stay fit, avoid stress, maintain a 2:1 balance between rest and activity. And keep in mind that by using the appropriate means and devices available to them to avoid fatigue and pain, you are not being lazy, but rather wise.
