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

Scottish Medicines and Scientific Advisory Committee Working Group
Post Polio Syndrome/Late Effects of Polio
• Success of interventions.
• Appropriate infrastructure of respiratory care.
2.5a Frequency of respiratory problems
As with other post polio symptoms, there is a wide range reported in the
literature for respiratory symptoms. Farbu et al 13 , in a series of 85 patients
found 20% had some impairment of peak expiratory flow, but only 2% had
dyspnoea. The Queensland Review 14 reported new breathing difficulties in
39% of subjects. An EFNS task force review 12 concluded that whilst
shortness of breath was a common symptom, respiratory function was often
normal and symptoms could be explained by cardiovascular deconditioning
and weight gain.
2.5b Sleep problems and PPS/LEOP
The incidence of sleep problems related to PPS/LEOP is similarly difficult to
estimate but all reviews indicate a number of reasons why sleep problems
might be commonly encountered:
• Obstructive sleep apnoea – imposed sedentary lifestyle with weight
gain, bulbar weakness.
• Central sleep apnoea – residual dysfunction of bulbar reticular neurons.
• Abnormal muscle movements – periodic leg movement in sleep [PLMS].
• Musculoskeletal discomfort causing sleep fragmentation.
2.5c Relevance of respiratory symptoms to a diagnosis of PPS/LEOP
No respiratory symptoms described in literature are specific to PPS/LEOP.
Respiratory involvement is indicated from the overall clinical picture with
‘alerts’ being:
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