Aug 23, 2012

Abrahão Augusto Juviniano Quadros post-poliomyelitis syndrome

Frequency and clinical manifestations of post-poliomyelitis syndrome in a brazilian tertiary care center

Frequência e manifestações clínicas da síndrome pós-poliomielite em um centro terciário brasileiro

Abrahão Augusto Juviniano QuadrosI; Mônica Tilli Reis Pessoa CondeII; Luis Fabiano MarinIII; Helga Cristina Almeida SilvaIII; Tatiana Mesquita e SilvaIII; Maria Bernadete Eduardo de PaulaIV; Roberto Dias Batista PereiraIII; Paulo Eduardo RamosIII; Gislane AbeIII; Acary Souza Bulle OliveiraIII
IDepartment of Neurology and Neurosurgery, Division of Neuromuscular Disorders, Federal University of São Paulo (Unifesp); Neurologic Rehabilitation Service of the Policlínica at Centro Universitário Adventista de São Paulo (Unasp), São Paulo SP, Brazil
IICenter for Disease Control and Prevention of the Municipal Secretary Office of Health, São Paulo SP, Brazil
IIIDepartment of Neurology and Neurosurgery, Division of Neuromuscular Disorders, Federal University of São Paulo (Unifesp), São Paulo SP, Brazil
IVCenter for Vigilance Epidemiology of the State Secretary Office of Health, São Paulo SP, Brazil


OBJECTIVE: To determine the frequency and clinical manifestations of patients with post-poliomyelitis syndrome (PPS) in a Brazilian division of neuromuscular disorders.
METHODS: A total of 167 patients with prior history of paralytic poliomyelitis was investigated for PPS, based on international diagnostic criteria. Other variables analyzed were: gender, race, age at poliomyelitis infection, age at PPS onset, and PPS symptoms.
RESULTS: One hundred and twenty-nine patients presented PPS, corresponding to 77.2% of the studied population. 62.8% were women and 37.2% were men. Mean age of patients with PPS at onset of PPS symptoms was 39.9±9.69 years. Their main clinical manifestations were: new weakness in the previously affected limbs (69%) and in the apparently not affected limbs (31%); joint pain (79.8%); fatigue (77.5%); muscle pain (76%); and cold intolerance (69.8%).
CONCLUSIONS: Most patients of our sample presented PPS. In Brazil, PPS frequency and clinical features are quite similar to those of other countries.
Key words: post-polio syndrome, poliomyelitis, prevalence.

México a la vanguardia en el Síndrome de Post Polio

Aug 21, 2012

Morphologic changes in the muscles of patients with postpoliomyelitis

Morphologic changes in the muscles of patients with postpoliomyelitis neuromuscular symptoms

  1. Marinos C. Dalakas, MD
    +Author Affiliations
  1. National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, MD. Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.


Thirty-five muscle biopsies were performed on 27 patients with postpoliomyelitis progressive muscular atrophy (PPMA) (8 patients had two biopsies) and 5 asymptomatic postpolio patients in an attempt to define diagnostic criteria for the newly weakening muscles and to provide insights into the mechanism of the disease. PPMA muscles that had been left weak since the original illness showed a mixture of myopathy with new and old denervation including group atrophy and nuclear clumps. Fully recovered or originally spared PPMA muscles showed signs of reinnervation and recent denervation. Perivascular or interstitial inflammatory cells (predominantly lymphocytes unrelated to phagocytosis) were noted in 40% of all the PPMA biopsies.
 It is concluded that (1) postpolio muscle biopsies show a spectrum of morphologic changes that depend on whether the biopsied muscle was originally affected and hadfully or partially recovered, (2) the newly weakened muscles show signs of recent denervation, and (3) the presence of reinnervation in the asymptomatic muscles and the patterns of recent and old denervation in PPMA muscles provide information regarding the degree of compensation of the surviving motor neurons and their apparent failure for further reinnervation via axonal sprouting.

FOOTNOTES Address correspondence and reprint requests to Dr. Dalakas, NINCDS, NIH, Building 10,

México a la vanguardia en el Síndrome de Post Polio

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