Key result
A history of nonparalytic polio was identified in four patients with postpolio syndrome, suggesting diagnostic criteria should be modified to include such cases.
Case Report (n=4)
The diagnostic criteria for postpolio syndrome should be expanded to include patients with a history of nonparalytic polio who exhibit compatible clinical and laboratory findings.
Should not yet alter postpolio syndrome diagnostic criteria; leaves open need for larger validation studies.
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.
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Halstead et al. (2000) conducted a case report in Postpolio syndrome (n=4). History of nonparalytic polio was evaluated. A history of nonparalytic polio was identified in four patients with postpolio syndrome, suggesting diagnostic criteria should be modified to include such cases.
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