Post-polio syndrome: Pathophysiological hypotheses, diagnosis criteria, drug therapy.
Post-polio syndrome (PPS) refers to a clinical disorder affecting polio survivors with sequelae years after the initial polio attack. These patients report new musculoskeletal symptoms, loss of muscular strength or endurance. PPS patients are tired, in pain and experience new and unusual muscular deficits, on healthy muscles as well as deficient muscles initially affected by the Poliovirus. Once a clinical diagnosis is established, the therapeutic options can be discussed. Some pathophysiological mechanisms have been validated by research studies on PPS (inflammatory process in cerebrospinal fluid [CSF] and cytokines of the immune system). Several studies have been conducted to validate medications (pyridostigmine, immunoglobulin, coenzyme Q10) or physical exercises protocols. This article focuses on the relevance and efficacy that can be expected from these therapeutics. Very few studies reported some improvements. Medications combined to individual and supervised exercise training programs are promising therapeutic strategies for PPS patients care management.
Boyer
F-C
FC
Pôle de médecine physique et de réadaptation, centre de référence des maladies neuromusculaires, hôpital universitaire Reims-Champagne-Ardenne, CHU Sébastopol, Reims, France. fboyer@chu-reims.fr
Tiffreau
V
V
Rapin
A
A
Laffont
I
I
Percebois-Macadré
L
L
Supper
C
C
Novella
J-L
JL
Yelnik
A-P
AP
D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D016262:Postpoliomyelitis Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
D002800:Cholinesterase Inhibitors; D005938:Glucocorticoids; D007136:Immunoglobulins; D014815:Vitamins; D014451:Ubiquinone; C024989:coenzyme Q10; D011729:Pyridostigmine Bromide; D011241:Prednisone