SMASAC Working Group Post Polio Syndrome - Scottish Health On ...

Scottish Medicines and Scientific Advisory Committee Working Group
Post Polio Syndrome/Late Effects of Polio
Section 2 - Diagnosis and management
2.1 Diagnostic approaches
There is no specific diagnostic test for post polio syndrome and some
clinicians still contest whether it is a specific diagnosis. It is a diagnosis of
exclusion. In considering a diagnosis of PPS or in attributing symptoms to the
late effects of polio in someone presenting with a possible history of polio, the
group suggests an approach based on the following initial questions:
• Did the individual have polio?
• Are their new clinical problems due to a different disease?
• If the patient appears to be have PPS/LEOP, are the symptoms
mechanical or due to new neurological deterioration?
Did the individual have polio?
It may seem strange to ask whether someone who has been told for years
they had polio ever had the condition, but this question cannot always be
answered with certainty. A number of studies have quoted figures of
between 5 and 15% of patients presenting to post-polio clinics whose
belief that they had polio could not be substantiated 1, 2, 3 . There is often
little clarity about the recall of the original illness and old medical records
may be unobtainable. In addition, some cases of polio had few
symptoms. The likelihood that the individual had polio can be assessed
by asking about when the illness took place; where the patient was treated
(certain hospitals were more likely to take polio cases); the length of time
the person was in hospital; any procedures that were undertaken (e. g.
plaster beds, tendon operations, respiratory support), the pattern of the
illness up to when the most severe disability was and what the patient was
like at discharge. It is also important to remember that some cases never
reached hospital and thus the above questions will not always be relevant.
This should be followed by clinical examination to establish whether the
features now are typical of previous polio. However, confirming the
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