“Non-Paralytic” Polio
Original Post: Why is it when polio is discussed in literature only “paralytic” is mentioned: Bulbar and
Bulbar/Spinal. Is “Non-Paralytic” the ugly step child?? Talking to a doctor today he said that there is NO SUCH THING as Non-Paralytic. He made me feel small.
Additional Post: It has only been in latter years that asymptomatic polio has been properly recognized and
this has only occurred when patients started to present with PPS. That certainly took a mindset change as
PPS is a diagnosis of exclusion - one of the first prerequisites was someone having a history of paralytic
poliomyelitis! It is now recognized, (certainly in Europe through medical centers and the European Polio
Union) that asymptomatic polio can result in PPS.
Without question, this should be the case when we realized that under WHO (World Health Organization)
definitions: a single paralytic case is counted as an epidemic. Therefore, up to 1,000 persons may have
had the virus pass through the gut. Only the few were paralyzed by this "gastro-enteritis virus". The
Poliovirus enters the body through the intestinal route, e.g. most commonly by mouth (although in rare
occasions it has been shown to enter the bloodstream directly through an open wound such as a cut).
Those who have had asymptomatic polio are just as much a part of the "polio family" as those affected with
paralysis.
Dr. Bruno’s Response: "Non-paralytic" polio can mean that you had:
1) No poliovirus invasion of neurons and no neuron damage;
2) Widespread neuron damage that was not severe enough in any spinal cord or brain area to cause
symptoms that could be detected but that now leaves you vulnerable to Post-Polio Sequelae;
3) Neuron damage that was severe enough in a spinal cord or brain area to cause symptoms, symptoms
that were not obvious but could be detected had someone tested you.
Two studies during the polio epidemics found that as many as 40% of "non-paralytic" polio survivors had
detectable muscle weakness WHEN THEY WERE TESTED in hospital. Once again, as with "the 3 types of
polio," there is a semantic problem, here is the difference between the physiology and clinical findings:
"Non-paralytic" polio meaning no neurons damaged and
"non-paralytic" polio meaning nobody bothered to see if you HAD muscle weakness caused by neuron damage.
Additional Post (from original): I understand now. You have made so much sense of my insensible youthful
experience. No one tested me. The weakness must have shown itself later, and always confused me.
Paralytic or Non-Paralytic – How do you know?
Dr. Bruno’s Response: The weakness was probably there at the beginning and nobody took the time to do
a manual muscle test. Sadly, some polio survivors weren't "bad enough" to get care at the peak of the two
epidemics.
And even more sad? Some parents realized there were weakness issues, and didn’t want to discuss them.