Poliomyelitis

1. What is the pathology behind polio?
2. What is the clinical presentation of polio?
3. What is the pathology behind post-polio syndrome? What are the symptoms?
4. What is the Halstead-Ross criteria for post-polio?
5. What is seen on EMG in polio and post-polio?
6. What is the treatment of post-polio?

Answers:
1. Degeneration of anterior horn cells.
2. Weakness, absent MSR, bulbar palsies, spared sensation.
3. Death of motor neuron due to aging and increased metabolic demand. Symptoms include weakness, atrophy, fatigue, arthralgia, myalgia, cold intolerance.
4. 1) H/o polio, 2) recovery of function, 3) stable for 15 years, 4) return of symptoms, 5) no other explanation for new symptoms.
5. Post-polio resembles old polio on EMG. There is abnormal activity, decr recruitment, and giant MUAPs.
6. Rehab, assistive devices, energy conservation. Avoid fatigue.