How is post-polio syndrome (PPS) diagnosed?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Physicians arrive at a diagnosis of post-polio syndrome (PPS) by completing a comprehensive medical history and neuromuscular examination and by excluding other disorders that could explain symptoms. Researchers and physicians typically use the following criteria to establish a diagnosis:

Prior paralytic poliomyelitis with evidence of motor neuron loss, as confirmed by the history of the acute paralytic illness, signs of residual weakness and atrophy of muscles on neuromuscular examination, and signs of nerve damage on electromyography (EMG). Rarely, people have subclinical paralytic polio, described as a loss of motor neurons during acute polio but with no obvious deficit. That prior polio now needs to be confirmed with EMG. Also, a reported history of nonparalytic polio may be inaccurate. A period of partial or complete functional recovery after acute paralytic poliomyelitis, followed by an interval (usually 15 years or more) of stable neuromuscular function. A gradual onset of progressive and persistent new muscle weakness or abnormal muscle fatigability (decreased endurance), with or without generalized fatigue, muscle atrophy, or muscle and joint pain. The onset may at times follow trauma, surgery, or a period of inactivity and can appear to be sudden. Less commonly, symptoms attributed to PPS include new problems with breathing or swallowing. Symptoms that persist for at least a year. Exclusion of other neuromuscular, medical, and orthopedic problems as causes of symptoms.

PPS may be difficult to diagnose in some people because other medical conditions can complicate the evaluation. Depression, for example, also is associated with fatigue and can be misinterpreted as PPS or vice versa.

Physicians may use magnetic resonance imaging (MRI), computed tomography (CT), neuroimaging, and electrophysiological studies as tools for investigating the course of decline in muscle strength. Less commonly, they will conduct a muscle biopsy or a spinal fluid analysis. It is important to remember that polio survivors may acquire other illnesses and should always have regular checkups and preventive diagnostic tests, such as mammograms, Pap smears, and colorectal examinations.

This answer is based on source information from National Institute of Neurological Disorders and Stroke.

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