Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Late effects of polioPost-polio sequelae ++ 138 Late effects of acute poliomyelitis344 Other paralytic syndromes357.4 Polyneuropathy in other diseases classified elsewhere ++ G14 Postpolio syndromeG63 Polyneuropathy in diseases classified elsewhere ++ 4A: Primary Prevention/Risk Reduction for Skeletal Demineralization 5H: Impaired motor function, peripheral nerve integrity, and sensory integrity associated with nonprogressive disorders of the spinal cord5G: Impaired Motor Function and Sensory Integrity Associated With Acute or Chronic Polyneuropathies6B Impaired Aerobic Capacity/Endurance Associated With Deconditioning6E: Impaired Ventilation and Respiration/Gas Exchange Associated With Ventilatory Pump Dysfunction or Failure7A: Primary Prevention/Risk Reduction for Integumentary Disorders7B: Impaired Integumentary Integrity Associated With Superficial Skin Involvement7C: Impaired Integumentary Integrity Associated With Partial-Thickness Skin Involvement and Scar Formation +++ Description ++ Onset of polio symptoms in people who suffered the effects of the poliovirus in the past +++ Essentials of Diagnosis ++ The poliovirus was eradicated in the US by 1994 due to the introduction of nationally required polio vaccines in 1955 and 1960.Two types of acute poliovirus infectionParalyticNonparalyticThe poliovirus attacks the motor neurons by destroying anterior horn cells. In the recovery process, anterior horn cells that survived the virus attempted to reinnervate muscle cells by extensive sprouting of any undamaged motor neuronsIn PPS, the motor neurons with the extensive sprouting appear to be degenerating and the associated muscle cells are losing innervationSeveral hypotheses are discussed for the onset of PPSThe degree of loss of anterior horn cells with the initial virus is the primary factorAge-related changes on the already limited motor neuron pool causes the “late-effect” symptomsOveruse and fatigue of the already weakened muscles are a factor in the development of new muscle weaknessNeurons that recovered from the initial attack were not physiologically normal, thus susceptible to premature aging and failureThe dormant poliovirus was reactivated by an unknown mechanism +++ General Considerations ++ Predictive factors for the onset of PPS areTime since initial polioDegree of weakness during the acute polioMuscle pain during exerciseJoint painRecent weight gainFor most of the people who suffered from polio in the past, the diagnosis of PPS can be devastatingOften patients will not identify deficits for several years after onsetSymptoms appear after a long period of neurological and functional stability after recovery from the acute poliovirus infectionSymptoms will appear in muscles that were not noticeably impacted from the initial poliovirus attack +++ Demographics ++ Estimates of the number of people with the original poliovirus are uncertain so the number of people with PPS is also uncertainThe time from polio to PPS onset is on average 35 years, but reportedly ranges from 10 to 80 years +++ Signs and Symptoms ++ General fatigue... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.