Post-Polio Syndrome

How is post-polio syndrome treated?

There are currently no effective pharmaceutical or specific treatments for the syndrome itself. However, a number of controlled studies have demonstrated that nonfatiguing exercises can improve muscle strength.

Researchers at the National Institutes of Health (NIH) have tried treating post-polio syndrome patients with alpha-2 recombinant interferon, but the treatment proved ineffective. Another study in which post-polio syndrome patients received high doses of prednisone demonstrated a mild improvement in their condition, but the results were not statistically significant. This, in addition to the drug's side effects, led researchers to recommend that prednisone not be used to treat post-polio syndrome.

In an effort to reduce fatigue, increase strength, and improve quality of life in post-polio syndrome patients, scientists conducted two controlled studies using low doses of the drug pyridostigmine (Mestinon). These studies showed that pyridostigmine is not helpful for post-polio syndrome patients.

In another controlled study scientists concluded that the drug amantadine (Symmetrel) is not helpful in reducing fatigue. And other researchers recently evaluated the effectiveness of modafinil (Provigil) on reducing fatigue and found no benefit.

Preliminary studies indicate that intravenous immunoglobin may reduce pain, increase quality of life, and improve strength. Research into its use is ongoing.

The future of post-polio syndrome treatment may center on nerve growth factors. Since post-polio syndrome may result from the degeneration of nerve sprouts, growth factors can target these and help to regenerate new ones. Unfortunately, one small study that NINDS scientists participated in showed that insulin-like growth factor (IGF-1), which can enhance the ability of motor neurons to sprout new branches and maintain existing branches, was not helpful.

Although there is no cure, there are recommended management strategies. Seek medical advice from a physician experienced in treating neuromuscular disorders. Do not attribute all signs and symptoms to prior polio. Use judicious exercise, preferably under the supervision of an experienced professional. Use recommended mobility aids, ventilatory equipment, and revised activities of daily living. Avoid activities that cause pain or fatigue that lasts more than 10 minutes. Pace daily activities to avoid rapid muscle tiring and total body exhaustion.

Learning about post-polio syndrome is important for polio survivors and their families. Management of post-polio syndrome can involve lifestyle changes. Support groups that encourage self-help, group participation, and positive action can be helpful. For some, individual or family counseling may be needed to adjust to the late effects of poliomyelitis, because experiencing new symptoms and using assistive devices may bring back distressing memories of the original illness.

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