Non-Paralytic Polio - Studies from the NIH

Nonparalytic Polio and Post Polio Syndrome

L S Halstead 1J K Silver

Abstract:

“We describe four cases of postpolio syndrome with typical histories, physical examination results, and electrodiagnostic evidence of extensive anterior horn cell disease, as well as the putative pathophysiology of postpolio syndrome in persons with histories of nonparalytic polio and the diagnostic implications for individuals older than 40 yr of age who are experiencing unexplained new weakness, fatigue, and muscle or joint pain. Although the diagnosis of postpolio syndrome traditionally has required a remote history of paralytic polio, many persons such as the ones described here with typical symptoms of postpolio syndrome have no clear history of paralytic disease and are being misdiagnosed. With this in mind, we believe that the diagnostic criteria for postpolio syndrome should be modified to include the following: a history of remote paralytic polio or findings on history, physical examination results, and laboratory studies compatible with poliovirus damage of the central nervous system earlier in life.”

Source: NIH – National Library of Medicine

Paralytic vs. "Nonparalytic" Polio: Distinction without a difference?

R L Bruno 1

Abstract:

“Nonparalytic polio (NPP) is commonly thought to be synonymous with ‘abortive polio,’ in which the poliovirus neither entered the central nervous system nor damaged neurons. Described are two epidemic illness-"The Summer Grippe" and Iceland disease-apparently caused by a low virulence but neuropathic type 2 poliovirus. Studies show that neuronal lesions in the brain and spinal cord and muscle weakness were common in NPP, and epidemiologic studies document late-onset weakness and fatigue in 14% to 42% of NPP survivors. These findings indicate that clinicians should not require a history of paralytic polio, electromyographic evidence of denervation, and new muscle weakness for the diagnosis of ‘Postpolio Syndrome’ but should be aware that NPP, and possibly even poliovirus-induced ‘minor illnesses,’ can be associated with acute central nervous system damage and late-onset muscle weakness and fatigue.”

Source: NIH – National Library of Medicine

Post Polio Syndrome from Non-paralytic Poliovirus Infection

Intern Med. 2022 Sep 15; 61(18): 2789–2792.

Kengo Maeda1 and Yoshiko Sugihara1:

Abstract:

“A 73-year-old man presented with muscle weakness and atrophy of his right arm. Atrophy of his left brachia and left calf had occurred 13 years before without any improvement or deterioration. His sister and cousin had a history of paralytic poliomyelitis. Serum poliovirus type 2 neutralizing antibody was elevated to 128×. Electromyography revealed chronic denervation potentials not only in the muscles affected previously but also in the unaffected muscles. Acute and chronic denervation potentials were found in the newly affected muscle. Postpolio syndrome should be considered in patients with unilateral muscular atrophy even when they have no history of paralytic poliomyelitis.”

Source for complete article: NIH - National Library of Medicine

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“One woman’s story of agony shows why childhood immunizations are so crucial” Ina Pinkney