1/18. Nonparalytic polio and postpolio syndrome.We describe four cases of postpolio syndrome with typical histories, physical examination results, and electrodiagnostic evidence of extensive anterior horn cell disease, as well as the putative pathophysiology of postpolio syndrome in persons with histories of nonparalytic polio and the diagnostic implications for individuals older than 40 yr of age who are experiencing unexplained new weakness, fatigue, and muscle or joint pain. Although the diagnosis of postpolio syndrome traditionally has required a remote history of paralytic polio, many persons such as the ones described here with typical symptoms of postpolio syndrome have no clear history of paralytic disease and are being misdiagnosed. With this in mind, we believe that the diagnostic criteria for postpolio syndrome should be modified to include the following: a history of remote paralytic polio or findings on history, physical examination results, and laboratory studies compatible with poliovirus damage of the central nervous system earlier in life.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/18. workplace disability management in postpolio syndrome.Postpolio syndrome (PPS) is generally defined as a clinical syndrome of new weakness, fatigue, and pain in individuals who have previously recovered from acute paralytic poliomyelitis. These new problems may lead to loss of employment as well as new deficits in instrumental activities in daily living (cleaning, washing, shopping, transportation, etc.), walking, climbing stairs, and personal assistance. We presented three cases of PPS with working disabilities in japan, and stated the issues confronted with. Particularly at the workplace, PPS individuals need special supports from both rehabilitation medicine and occupational health services, including improved nutrition, achieving ideal body weight, regular and sensible exercise, frequent checkups, and modifying working conditions.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
3/18. Management of a patient with post-polio syndrome.PURPOSE: To describe the current understanding of the management of patients with post-polio syndrome (PPS) and relate the research to a case study. DATA SOURCES: Standard neurology textbooks, current review and research articles, and a case study. CONCLUSIONS: More than 15 years following a diagnosis of poliomyelitis, a new onset of weakness, fatigue, joint pain, decreased endurance, muscle atrophy, gait disturbance, respiratory and swallowing problems, cold intolerance, and difficulties with activities of daily living might indicate a neurologic disorder called PPS. IMPLICATIONS FOR PRACTICE: Non-post-polio causes of weakness, fatigue or pain must be excluded before making a diagnosis of PPS. Approaches to management vary depending on the symptoms and level of disability. Reducing physical and emotional stress, energy conservation, adequate rest, modification of work and home environments, joint protection, and the use of orthoses, adaptive equipment, or mobility aids can reduce fatigue and preserve function.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
4/18. Post-polio syndrome: a review and case report.A 21-year-old Thai man presented with progressive weakness and atrophy of both hands for 2 years. His left leg was atrophic and weak secondary to poliomyelitis since he was 8 months old. physical examination showed that there was atrophy of both hands and forearms as well as left leg. sensation was normal. Deep tendon reflexes were normal except for hyporeflexia of left leg. EMG showed chronic denervation pattern in the recent atrophic muscles and in normal power muscles. Motor and sensory nerve conductions were normal. biopsy of forearm muscle revealed degeneration and fibrosis of muscle fibers. These findings were compatible with post-polio syndrome (PPS) which presents in patients with late paralysis following poliomyelitis. It is not a form of amyotrophic lateral sclerosis although some clinical similarities exist. Weakness from PPS may lead to musculoskeletal pain and increased functional disability. Proper rehabilitation program is to maintain his functional status and allow him to continue to live as independently as possible by regular exercise without stressing joints and muscles.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
5/18. rehabilitation for postpolio sequelae.BACKGROUND: Postpolio sequelae (PPS) are new, late manifestations that occur many years after the initial poliomyelitis infection. recurrence of symptoms and fear of reactivation of the polio virus is particularly distressing to polio survivors. OBJECTIVE: This article outlines the diagnosis, pathophysiology, and management of PPS disabilities using a case vignette. DISCUSSION: Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. diagnosis can be complicated particularly in nonparalytic cases of poliomyelitis. Disabilities in PPS may not be obvious to the observer but significantly affect the quality of life of the PPS patient. Previous rehabilitation intervention focussed on physical effort and determination to overcome disability at all costs. The treatment in PPS is now modified, and aggressive physical measures that may exacerbate muscle weakness are avoided. Most disabilities in PPS can be well managed with rehabilitation interventions that address limitations in patient activities of daily living, mobility and cardiopulmonary fitness.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
6/18. Post-poliomyelitis syndrome: case report and review of the literature.INTRODUCTION: postpoliomyelitis syndrome (PPS) refers to the new neuromuscular symptoms that occur in patients years after their acute poliomyelitis has stabilised. PPS cases seen now are probably related to the poliomyelitis epidemics of the 1940s and 1950s. CLINICAL PICTURE AND INVESTIGATION: A 57-year-old Chinese man with a history of poliomyelitis affecting both lower limbs presented with left upper limb weakness. physical examination revealed atrophy of his left upper limb muscles. There were fasciculations in the biceps and brachioradialis muscles. electromyography revealed ongoing denervation neurogenic units in the C5 to TI myotomes comparable with PPS. CONCLUSION: The aim of this paper is to review the present situation and to give a short summary of PPS, which can be difficult to diagnose because the symptoms of presentation are usually non-specific. We describe a case of PPS and review the current literature.- - - - - - - - - - ranking = 0.35959313190762keywords = upper (Clic here for more details about this article) |
7/18. Respiratory failure in a patient with antecedent poliomyelitis: amyotrophic lateral sclerosis or post-polio syndrome?We report a 69-year-old man who developed paralytic poliomyelitis in childhood and then decades later suffered from fatal respiratory failure. Six months before this event, he had progressive weight loss and shortness of breath. He had severe muscular atrophy of the entire right leg as a sequela of the paralytic poliomyelitis. He showed mild weakness of the facial muscle and tongue, dysarthria, and severe muscle atrophy from the neck to proximal upper extremities and trunk, but no obvious pyramidal signs. Electromyogram revealed neurogenic changes in the right leg, and in the paraspinal, sternocleidomastoid, and lingual muscles. There was a slight increase in central motor conduction time from the motor cortex to the lumbar anterior horn. Pulmonary function showed restrictive ventilation dysfunction, which was the eventual cause of death. Some neuropathological features were suggestive of amyotrophic lateral sclerosis (ALS), namely Bunina bodies. In patients with a history of paralytic poliomyelitis who present after a long stable period with advanced fatal respiratory failure, one may consider not only respiratory impairment from post-polio syndrome but also the onset of ALS.- - - - - - - - - - ranking = 0.17979656595381keywords = upper (Clic here for more details about this article) |
8/18. Insidious phrenic nerve involvement in postpolio syndrome.A 49-year-old woman with amyotrophic sequelae of poliomyelitis experienced progressive left upper limb weakness and breathing discomfort while walking that had developed over one year prior to presentation. She had flaccid quadriplegia which was more marked in the left upper limb, with the C4- and C5-innervated muscles being most severely affected. Chest radiographs double exposed at maximal inspiration and expiration revealed poor respiratory movements in the left hemidiaphragm. phrenic nerve conduction study demonstrated conspicuous diaphragmatic paralysis on the left side. The electrophysiological study supports radiological findings and provides useful evidence for insidious phrenic nerve involvement in postpolio syndrome.- - - - - - - - - - ranking = 47.754913364849keywords = breathing, upper (Clic here for more details about this article) |
9/18. Improvement in exercise capacity after nocturnal positive pressure ventilation and tracheostomy in a postpoliomyelitis patient.Progressive neuromuscular symptoms years after recovery from acute paralytic poliomyelitis have been termed the PPS. We describe a 52-year-old man who contracted poliomyelitis at age 9 years who fully recovered and 33 years later developed progressive dyspnea. Neurologic evaluation revealed bilateral paralysis of the vocal cords, generalized weakness, and accentuated mouth occlusion pressure and ventilatory responses to hypercapnic, hyperoxic breathing. An EMG and muscle biopsy showed changes consistent with acute and chronic denervation. Cardiopulmonary exercise evaluation demonstrated a pulmonary mechanical limit with excessive ventilation relative to CO2 output. tracheostomy and nocturnal positive pressure ventilation resulted in increased respiratory muscle strength, normalization of ventilatory drive and marked improvement in exercise capacity.- - - - - - - - - - ranking = 47.395320232942keywords = breathing (Clic here for more details about this article) |
10/18. hypnosis for postpolio syndrome & Type-A behavior.Many of the hundreds of thousands of survivors of polio are now developing postpolio syndrome. Symptoms include progressive muscle weakness, fatigue, decreased endurance, joint and muscle pain, weight gain, respiratory difficulties, and sleep disturbance, often precipitated or exacerbated by a Type-A personality pattern. A postpolio patient with Type-A personality was taught self-hypnosis as a vital component of treatment. Pre-post testing included the Profile of Mood States, the State-Trait anxiety Inventory, the State-Trait anger Inventory, and the Personal orientation Inventory; the patient's spouse was interviewed during the follow-up. At the 6-month follow-up, improvements were documented in pain level, depression, self-regard, self-acceptance, capacity for intimate contact, time competence (living in the present), confusion, anxiety, insomnia, and in trait and state anger. Only a mild improvement occurred in fatigue, and no improvement was found in weight control. Follow-up at 12 months confirmed the maintenance of improvements. Self-hypnosis training may prove extremely helpful for postpolio patients and may prove helpful in modifying central characteristics of Type-A personality.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
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