Vol. 5, No. 11, p. 631-639 - Dec. 31, 2018
Post-Polio Syndrome
Monalisa Pereira Motta , Abrahão Augusto Juveniano Quadros , Mônica de Souza Brito Conti and Acary Souza Bulle Oliveira
Abstract
Among the late effects of poliomyelitis is the Post-Polio Syndrome (PPS), characterized by increased muscle strength loss, abnormal fatigue and pain after a period of stability of at least 15 years. The incidence and prevalence of PPS are unknown in the world and in Brazil, depending on the diagnostic criteria. The diagnosis of PPS is made by exclusion and there is no specific laboratory test, these only help to rule out other diseases. There is no curative treatment for PPS. Its etiology remains unknown. Strategies for their clinical management aim reducing muscle overusing and a balance active lifestyle is recommended to minimize the symptoms.
Keywords
Post-Poliomyelitis Syndrome; Neuromuscular disorders; Treatment; Management.
DOI
10.21472/bjbs.051102
Full text
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References
Agre, J. C.; Rodriquez, A. A.; Franke, T. M. Strength, endurance, and work capacity after muscle strengthening
exercise in postpolio subjects. Archives of Physical Medicine & Rehabilitation, v. 78, no. 7,
p. 681-686, 1997. Available from: <https://www.archives-pmr.org/article/S0003-9993(97)90073-3/pdf<.
Accessed on: Apr. 23, 2018.
Burger, H.; Marincek, C. The influence of Post-Polio Syndrome on independence and life satisfaction. Disability
and Rehabilitation, v. 22, no. 7, p. 318-322, 2000.
Bruno, R. L.; Zimmerman, J. R.; Creange, S. J.; Lewis, T.; Molzen, T.; Frick, N. M. Bromocriptine in the treatment
of post-polio fatigue: A pilot study with implications for the pathophysiology of fatigue. American Journal of
Physical Medicine & Rehabilitation, v. 75, no. 5, p. 340-347, 1996.
Conde, M. T. R. P.; Oliveira, A. S. B.; Quadros, A. A. J.; Moreira, G. A.; Silva, H. C. A.; Pereira, R. D. B.; Silva,
T. M.; Tufik, S.; Waldman, E. A. Post-Polio Syndrome: Epidemiologic and prognostic aspects in Brazil. Acta
Neurologica Scandinavica, v. 120, p. 191-197, 2009. https://doi.org/10.1111/j.1600-0404.2008.01142.x
Chan, K. M.; Strohschein, F. J.; Rydz, D.; Allidina, A.; Shuaib, A.; Westbury, C. F. Randomized controlled trial of
Modafinil for the treatment of fatigue in postpolio patients. Muscle Nerve, v. 33, p, 138-141, 2006.
https://doi.org/10.1002/mus.20437
Dalakas, M. C. Intravenous immuneglobulin in autoimmune neuromuscular diseases. JAMA, v. 291, no. 19, p. 2367-2375,
2004. https://doi.org/10.1001/jama.291.19.2367
Dalakas, M. C. The Post-polio syndrome as an evolved clinical entity: Definition and clinical description. Annals of
the New York Academy of Sciences, v. 753, p. 68-80, 1995. https://doi.org/10.1111/j.1749-6632.1995.tb27532.x
Dinsmore, S.; Dambrosia, J.; Dalakas, M. C. A double-blind, placebo-controlled trial of high-dose prednisone for the
treatment of Post-Poliomyelitis Syndrome. Annals of the New York Academy of Sciences, v. 753, p. 303-313, 1995.
https://doi.org/ 10.1111/j.1749-6632.1995.tb27556.x
Farbu, E. Update on current and emerging treatment options for Post-Polio Syndrome. Therapeutics and Clinical Risk
Management, v. 6, p. 307-313, 2010. Available from: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2909497/pdf/tcrm-6-307.pdf>.
Accessed on: Apr. 23, 2018.
Farbu, E.; Rekand, T.; Vik-Mo, E.; Lygren, H.; Gilhus, N. E.; Aarli, J. A. Post-Polio Syndrome patients treated with
intravenous immunoglobulin: A double-blinded randomized controlled pilot study. European Journal of Neurology,
v. 14, no. 1, p. 60-65, 2007. https://doi.org/10.1111/j.1468-1331.2006.01552.x
Gonzalez, H.; Khademi, M.; Andersson, M.; Piehl, F.; Wallström, E.; Borg, K.; Olsson, T. Prior poliomyelitis-IVIg
treatment reduces proinflammatory cytokine production. Journal of Neuroimmunology, v. 150, n. 1/2, p. 139-144,
2004. https://doi.org/10.1016/j.jneuroim.2004.01.010
Gonzalez, H.; Sunnerhagen, K. S.; Sjoberg, I.; Kaponides, G.; Olsson, T.; Borg, K. Intravenous immunoglobulin for
Post-Polio Syndrome: A randomised controlled trial. The Lancet, Neurology, v. 5, no. 6, p. 493-500, 2006.
https://doi.org/10.1016/S1474-4422(06)70447-1
Halstead, L. S. Assessment and differential diagnosis for Post-Polio Syndrome. Orthopedics, v. 14, no. 11,
p. 1209-1217, 1991.
Horemans, H. L. D.; Nollet, F.; Beelen, A.; Drost, G.; Stegeman, D. F.; Zwarts, M. J.; Bussmann, J. B. J.; de Visser, M.;
Lankhorst, G. J. Pyridostigmine in Postpolio Syndrome: No decline in fatigue and limited functional improvement. Journal
of Neurology, Neurosurgery & Psychiatry, v. 74, no. 12, p. 1655-1661, 2003. https://doi.org/10.1136/jnnp.74.12.1655
Howard, R. S. Poliomyelitis and the Postpolio Syndrome. BMJ, v. 330, p. 1-5, 2005. https://doi.org/10.1136/bmj.330.7503.1314
Jubelt, B.; Cashman, N. R. Neurological manifestations of the Post-Polio Syndrome. Critical Reviews in Neurobiology,
v. 3, p. 199-220, 1987.
Khan, F. Rehabilitation for postpolio sequelae. Australian Family Physician, v. 33, no. 8, p. 621-624, 2004. Available
from: <https://www.racgp.org.au/afpbackissues/2004/200408/20040803khan.pdf.
Accessed on: Apr. 23, 2018.
Kaponides, G.; Gonzalez, H.; Olsson, T.; Borg, K. Effect of intravenous immunoglobulin in patients with Post-Polio Syndrome:
An uncontrolled pilot study. Journal of Rehabilitation Medicine, v. 38, no. 2, p. 138-140, 2006. https://doi.org/10.1080/16501970500441625
Motta, M. P. Efeito terapêutico do uso da L-carnitina+piracetam na fadiga e na força muscular de pacientes com
Síndrome Pós-Poliomielite (SPP): estudo clínico randomizado, duplo-cego, controlado com placebo.
São Paulo: Universidade Federal de São Paulo, Escola Paulista de Medicina, 2017. (Master thesis).
Neves, M. A. O.; Mello, M. P.; Reis, J. P. B.; Rei, A. M.; Antonioli, R. S.; Nascimento, O. J. M.; Freitas, M. R. G.
A Síndrome Pós-Polio e o processo de reabilitação motora: relato de caso. Revista
Neurociências, v. 15, no. 4, p. 321-325, 2007. Available from: <http://www.revistaneurociencias.com.br/edicoes/2007/RN 15 04/Pages from RN 15 04-13.pdf>.
Accessed on: Apr. 23, 2018.
Nollet, F.; Horemans, H. L. D.; Beelen, A.; Drost, G.; Zwarts, M. J.; de Visser, M.; Lankhorst, G. J. Pyridostigmine in
Postpolio Syndrome: A randomized double-blinded trial. Neurology, v. 58, no. 2, p. 199-200, 2002.
Oliveira, A. S. B.; Maynard, F. M. Síndrome Pós-Poliomielite: aspectos neurológicos. Revista
Neurociências, v. 10, no. 1, p. 31-34, 2002. Available from: <http://www.revistaneurociencias.com.br/edicoes/2002/RN 10 01/RN 10 01 5.pdf>.
Accessed on: Apr. 23, 2018.
Oliveira, A. S. B.; Quadros, A. A. J. Síndrome Pós-Poliomielite: orientações para profissionais
de saúde. São Paulo: SES/SP, 2008. (Versão para Internet). Available from: <http://www.saude.sp.gov.br/resources/ses/perfil/profissional-da-saude/homepage//sindrome_pos_poliomielite_.pdf>.
Accessed on: Apr. 23, 2018.
On, A. Y.; Oncu, J.; Uludag, B.; Ertekin, C. Effects of Lamotrigine on the symptoms and life qualities of patients with
Post-Polio Syndrome: A randomized, controlled study. Neuro Rehabilitation, v. 20, no. 4, p. 245-251, 2005.
Orsini, M.; Mello, M. P.; Antonioli, R. S.; Nascimento, O. J. M.; Freitas, M. R. G. A Síndrome Pós-Pólio
e o processo de reabilitação motora: relato de caso. Revista Neurociências, v. 15, p. 321-325, 2008.
Available from: <http://www.revistaneurociencias.com.br/edicoes/2007/RN 15 04/Pages from RN 15 04-13.pdf>.
Accessed on: Apr. 23, 2018.
Peel, M. M.; Cooke, M.; Lewis, H. J.; Lea, R. A.; Moyle, W. A randomized controlled trial of coenzyme Q10 for fatigue in the
late-onset sequelae of poliomyelitis. Complementary Therapies in Medicine, v. 23, no. 6, p. 789-793, 2015. https://doi.org/10.1016/j.ctim.2015.09.002
Quadros, A. A. J.; Conde, M. T. R. P.; Marin, L. F.; Silva, H. C. A.; Mesquita e Silva, T.; Paula, M. B. E.; Pereira, R. D. B.;
Ramos, P. E.; Abe, G.; Oliveira, A. S. B. Frequency and clinical manifestations of Post-Poliomyelitis Syndrome in a Brazilian
tertiary care center. Arquivos de Neuro-Psiquiatria, v. 70, no. 8, p. 571-573, 2012. https://doi.org/10.1590/S0004-282X2012000800002
Ramlow, J.; Alexander, M.; LaPorte, R.; Kaufmann, C.; Kuller, L. Epidemiology of the Post-Polio Syndrome. American Journal
of Epidemiology, v. 136, no. 7, p. 769-786, 1992.
Rosa, L. N.; Cunha, M. C. B.; Franco, R. C. Qualidade de vida em indivíduos portadores da Síndrome Pós-Pólio.
Arquivos Médicos do ABC, v. 31, no. 1, p. 18-22, 2006. Available from: <https://www.portalnepas.org.br/amabc/article/viewFile/230/226>.
Accessed on: Apr. 23, 2018.
Rekand, T.; Korv, J.; Farbu, E.; Roose, M.; Gilhus, N. E.; Langeland, N.; Aarli, J. A.. Lifestyle and late effects after
poliomyelitis. A risk factor study of two populations. Acta Neurologica Scandinavica, v. 109, no. 2, p. 120-125,
2004. https://doi.org/10.1034/j.1600-0404.2003.00186.x
Rowland, L. P.; Bach, J. R.; Borg, K.; Cashman, N. R.; Dalakas, M. C.; Dean, E.; Halstead, L. S.; Headley, J. L.; John,
T. J.; Johnston, R. B.; Olkin, R.; Perlman, S. L.; Trojan, D. A.; Vickrey, B. G.; Wendling, W. W. March of Dimes
International Conference on Post-Polio Syndrome: Identifying best practices in diagnosis & care. White Plains, NY: March of Dime, 2000. Available
from: <https://www.polioplace.org/sites/default/files/files/MOD- Identifying.pdf>.
Accessed on: Apr. 23, 2018.
Skough, K.; Krossén, C.; Heiwe, S.; Theorell, H.; Borg, K. Effects of resistance training in combination with
coenzyme Q10 supplementation in patients with post-polio: A pilot study. Journal of Rehabilitation Medicine,
v. 40, no. 9, p. 773-775, 2008. https://doi.org/10.2340/16501977-0245<
Stein, D. P.; Dambrosia, J. M.; Dalakas, M. C. A double-blind, placebo-controlled trial of amantadine for the treatment
of fatigue in patients with the Post-Polio Syndrome. Annals of the New York Academy of Sciences, v. 753, no. 1,
p. 296-302, 1995. https://doi.org/10.1111/j.1749-6632.1995.tb27555.x
Trojan, D. A.; Cashman, N. R. An open trial of pyridostigmine in Post-Poliomyelitis Syndrome. Canadian Journal of
Neurological Sciences, v. 22, no. 3, p. 223-227, 1995. https://doi.org/10.1017/S0317167100039883
Trojan, D. A.; Cashman, N. R. Post-Poliomyelitis Syndrome. Muscle Nerve, v. 31, no. 1, p. 6-19, 2005. https://doi.org/10.1002/mus.20259
Trojan, D. A.; Cashman, N. R.; Shapiro, S.; Tansey, C. M.; Esdaile, J. M. Predictive factors for Post-Poliomyelitis Syndrome.
Archives of Physical Medicine and Rehabilitation, v. 75, p. 770-777, 1994. Available from: <https://www.archives-pmr.org/article/0003-9993(94)90134-1/pdf. Accessed on: Apr. 23, 2018.
Trojan, D. A.; Collet, J.-P.; Shapiro, S.; Jubelt, B.; Miller, R. G.; Agre, J. C.; Munsat, T. L.; Hollander, D.; Tandan, R.;
Granger, C.; Robinson, A.; Finch, L.; Ducruet, T.; Cashman, N. R. A multicenter, randomized, double-blinded trial of pyridostigmine
in Postpolio Syndrome. Neurology, v. 53, no. 6, p. 1225-1233, 1999. https://doi.org/10.1212/WNL.53.6.122
Vasconcelos, O. M.; Prokhorenko, O. A.; Salajegheh, M. K.; Kelley, K. F.; Livornese, K.; Olsen, C. H.; Vo, A. H.; Dalakas,
M. C.; Halstead, L. S.; Jabbari, B.; Campbell, W. W. Modafinil for treatment of fatigue in Post-Polio Syndrome: A randomized
controlled trial. Neurology, v. 68, no. 20, p. 1680-1686, 2007. https://doi.org/10.1212/01.wnl.0000261912.53959.b