¿Qué ocasiona el Síndrome de la Pospolio (SPP)?
¿Cómo se diagnostica el Síndrome de la Pospolio (SPP)?
¿Cuál es el tratamiento para el Síndrome de la Postpolio (SPP)?
Otros factores de crecimiento que ahora se están investigando tienen propiedades similares.
Acerca del ejercicio pacientes con SPP
Pregunta Frecuente de Las Personas con SPP
¿Qué hay acerca de las investigación que se han realizando?
- Fatigue - In individuals without polio or PPS, the functional consequences of aging and loss of motor units may be unnoticeable until a very advanced age. In the individual with PPS, any further loss of strength may be more readily apparent. In contrast to patients with chronic fatigue syndrome, postpolio fatigue is prominent in the early hours of the afternoon and decreases after brief periods of rest. PPS-related fatigue usually does not prevent patients from working.
- Pathogenesis can include chronic pain, type A personality, depression, dysfunctional reticular-activated system, sleep disorders, and respiratory dysfunction.
- PPS produces somnolence and difficulty in concentrating and remembering.
- Pathogenesis may be metabolic exhaustion of the enlarged motor units, neuromuscular junction transmission defects, scarring within the motor neurons, or loss of motor units due to aging.
- PPS produces decreased muscular endurance and increased muscular fatigability.
- A number of functional etiologies for weakness have been hypothesized, including disuse, overuse, and chronic weakness, as well as weight gain.
- Asymmetrical and scattered weakness may be present.
- Some authors have found evidence that previously unaffected muscles later become weak; in these cases, they discovered that the patient was unaware or had not been told that the particular muscle had been affected during the acute episode.
- Muscle pain1,3
- Deep aching pain may be a component of a myofascial pain syndrome or fibromyalgia.
- This feature is extremely prevalent in PPS. Using a retrospective, cross-sectional survey, Stoelb et al investigated the frequency and most common sites of pain in patients with postpolio syndrome.4Pain symptoms were reported by 57 (90.5%) of the 63 study participants; pain was reported most often in the shoulders, legs, hips, and lower back, with the most intense pain occurring in the legs, knees, wrists, head, and lower back.
- Gait disturbance - Difficulty with gait is caused by progressive weakness, pain, osteoarthritis, or joint instability; it is common in patients who previously used assistive devices but later discarded them.
- Respiratory problems
- Respiratory disorders are most prevalent in patients with residual respiratory muscle weakness.
- These changes cause chronic microatelectasis, diminished pulmonary compliance, increased chest wall tightness, chronic alveolar hypoventilation, decreased cough and expiratory flow, and decreased clearing of secretions.
- The new respiratory difficulties are not only related to new respiratory muscle weakness but also to scoliosis, pulmonary emphysema, cardiovascular insufficiency, or poor posture.
- A central component also may occur because acute bulbar polio often affects the medullary structures, including the reticular formation and sleep regulatory system.
- Swallowing problems
- These difficulties can occur in patients with bulbar and nonbulbar postpolio.
- Subclinical asymmetrical weakness in the pharyngeal constrictor muscles is almost always present in all postpolio muscular atrophy patients, including those who do not complain of new swallowing difficulties.
- Autonomic dysfunction - The cause is unclear; the peripheral component could include muscular atrophy and, therefore, diminished heat production.
- Sleep apnea
- This disorder is not uncommon in patients left with residual bulbar dysfunction or severe respiratory compromise.
- Sleep apnea appears to be due to a combination of the following:
- Central apnea, due to a residual dysfunction of the surviving bulbar reticular neurons
- Obstructive apnea, due to pharyngeal weakness and increased musculoskeletal deformities from scoliosis or emphysema
- Postpolio muscular atrophy, resulting in diminished muscle strength of the respiratory, intercostal, and abdominal muscle groups
- Flat-back syndrome
- Another possible symptom in some patients with PPS is the flat-back syndrome, which consists of the inability to stand erect because of forward flexion of the trunk and pain in the low back and legs.
- The flat-back syndrome typically occurs in patients with diminished lumbar lordosis as a result of instrumentation of the spine for scoliosis, vertebral fracture, or degenerative joint disease.
- The trunk extensor musculature plays an essential role in maintaining upright posture, and it may be that PPS-related weakness in this musculature represents a major contributing factor to the flat-back syndrome in these patients.
|México a la vanguardia en el Síndrome de Post Polio|