New dimensions to poliomyelitis

About 22% of persons who suffer from acute paralytic poliomyelitis 20 to 30 years ago and were fully rehabilitated with maximal functional recovery began to experience new symptoms termed "Post-polio Sequelae" (PPS). These include unaccustomed fatigue, weakness in muscles previously affected or apparently unaffected, new joint pains, respiratory difficulties and intolerance to cold. Predictors for PPS are development of acute attack of paralytic polio before 10 years of age, involvement of all four limbs and having needed a ventilator during acute stage. The functional decompensation in PPS is presumed to be due to loss of normal neurones by aging and by metabolic fatigue of stressed neurones over passing years. Joint deformities due to muscular imbalance are also responsible for some of the symptoms. Treatment consists of reassurance and use of assistive devices and assistive exercises. The extent of problem of PPS is not known in India.