| HALLMARK IS NEW WEAKNESS
The hallmark symptom of postpolio syndrome is new weakness, which may occur in muscles known to be previously affected or in muscles that were thought to be normal.3 The patient may report difficulty with walking or lifting items, falls, needing more assistance with transfers (eg, moving from the bed or commode to the wheelchair), and being less able to do functional tasks. The weakness characteristically worsens with increased activity and is most pronounced at the end of the day.
Symptoms may also include dyspnea on exertion due to respiratory muscle weakness, other breathing or swallowing problems, pain (myalgias), cold intolerance, and unaccustomed fatigue. New muscle atrophy may also be present.8
Pain can be due to factors related to the history of polio, but which are not classifiable as postpolio syndrome. For example, a patient may present with left leg paralysis due to the initial polio and report increased limping and pain in the right hip (i.e., the “good” leg). The new symptoms may be due to osteoarthritis of the hip, which is more likely to occur in a polio survivor without good muscular support around the hip and after years of additional wear and tear.
Postpolio muscle pain classically occurs in the muscles rather than in the joints. The pain is often described as aching, cramping, burning, or a “tired” feeling. It frequently occurs at night or after the person has been very active.8
Numbness or paresthesias are not typical symptoms of postpolio syndrome.
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