Neuropathy and Post-Polio

Question: Is there a way of distinguishing between diabetic neuropathy in motor neurons vs. polio / post- polio neuropathy? I’ve had diabetes for 20 years and PPS for about 2, but yet some specialists just off- handedly dismiss my motor neuropathy in my legs as "probably" diabetes.

Dr. Bruno’s Response:

A Nerve conduction study should've told the tale. See: EMG vs Nerve Conduction Study. There is no such thing as a post-polio or polio neuropathy. The poliovirus damages the neuron in the spinal cord, not the axon going to the muscle. What's more the polio virus doesn't damage sensory neurons or their axons. So if you have "nerve pain" it's not due to having had polio.

There are conditions that cause motor nerves to lose their myelin. In people who are middle-aged a common cause is an autoimmune process. Slowed conduction along motor nerves can be associated with muscle weakness because not all of the muscle fibers are being stimulated at the same time; think of listening to someone . . . . speaking . . . very . . . slowly and you not being able to quickly understand the speaker.
It sounds as though your doctor should be looking for some cause for the motor demyelination other than polio.

Article Reviewed by Richard L. Bruno, HD, PhD 2022