by Vonda J. Sines

Created on: August 15, 2009

Among illnesses, post-polio syndrome (PPS) stands belongs to an elite group. It's one of a handful of conditions that strike patients who have previously experienced a related illness.

PPS affects individuals who have suffered from and survived an acute attack of the poliomyelitis virus. It can result in the weakening of muscles unaffected by the initial illness, those that were already damaged, or both types. Its symptoms tend to develop gradually.

According to the National Institute of Neurological Disorders and Stroke, the number of individuals affected by post-polio syndrome is unclear. Various studies suggest that anywhere between 25 and 60 percent of polio survivors in the United States could suffer from PPS at some point. This represents nearly 450,000 people at risk.

While there is no cure or effective pharmaceutical or other treatment for PPS, several studies have shown that non-fatiguing exercises can improve a patient's muscle strength. When National Institutes of Health (NIH) scientists treated patients with alpha-2 recominant interferon, the treatment was deemed unsuccessful.

Mild improvement resulted after a different study in which doctors administered high doses of the steroid prednisone. Because of this drug's side effects and the fact that the results were not statistically significant, medical personnel recommended that prednisone should not be used for post-polio syndrome.

Two additional controlled studies utilized the drug pyridostigmine (Mestinon) in low doses. This drug was deemed not helpful for patients. In another controlled study, researchers used the drug amantadine. However, it proved an ineffective treatment for reducing fatigue in PPS patients, as did the drug modifinil (Provigil).

Some of the current research on treatment for post-polio syndrome involves studying intravenous immunoglobin. Preliminary results hint that it might reduce pain, increase the patient's quality of life, and improve strength.

The Institute believes that future investigations of possible PPS treatments might center on nerve growth factors since the condition potentially results from the degeneration of nerve sprouts. Scientists are considering growth factors to target the affected sprouts and spur regeneration of new ones.

While doctors cannot offer their PPS patients a cure, they can offer management strategies to help deal with their symptoms. One piece of advice is to work with a doctor who has experience treating neuromuscular disorders.

Physicians also suggest that individuals with post-polio syndrome take advantage of appropriate exercise, ideally supervised by an experienced professional. Patients can utilize mobility aids, ventilation equipment and a revised daily schedule to cope. They should avoid activities that result in any pain or fatigue that persists for more than 10 minutes and should generally pace themselves each day to avoid becoming overly tired.

For many PPS patients, dealing with the condition involves making significant lifestyle changes. Taking advantage of a support group or individual or family counseling can make life much easier.

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