Unilateral multilevel cervical radiculopathies as a late effect of poliomyelitis. A case report

Myotonic dystrophy mimicking postpolio syndrome in a polio survivor

We describe a 38-yr-old polio survivor with newly developed weakness from myotonic dystrophy. He suffered muscle atrophy and weakness in his legs as a result of poliomyelitis at the age of 3 yrs. After a stable interval of about 30 yrs, he felt new weakness and fatigue in his legs. Electromyography revealed generalized myotonic discharges, early recruitment, and findings of chronic denervation in his left leg. Genetic testing was consistent with myotonic dystrophy type 1. A biopsy from the right gastrocnemius revealed findings of both myotonic dystrophy and chronic denervation. This case report shows the importance of considering other uncommon conditions in the differential diagnoses of postpolio syndrome.

Post-polio syndrome and total health status in a prospective hospital study

New loss of function among patients with previous polio is frequently reported and has several causes. All patients referred to the Department of Neurology, Haukeland University Hospital, Bergen, for 13 months during 2000-2001 with diagnosis late effects of polio were examined prospectively to identify their symptoms and loss of function. Eighty-five patients aged 47-91 years with mean of 61 years were included. The most common complaints were pain (44%), muscular weakness (27%), and fatigue (16%). Muscular weakness occurred in lower limbs in 75%, in respiratory muscles in only 5%. Walking in stairs was impaired in 72% and outdoor walking in 65%. Seventeen patients (19%) reported no loss of function. Post-polio syndrome was diagnosed in 26% of the patients. Polio-related loss of function including cervical and lumbosacral radiculopathies, mononeuropathies and degenerative joint disease were found in an additional 53%. Eleven patients (13%) had distinct non-polio-related disorders that caused new loss of function. The remaining 8% had a stable condition. In conclusion, the majority of polio patients who seek hospital, experience a new loss of function because of polio-related disorders. A careful neurological examination is necessary to identify the correct diagnosis and treatment.

Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors

The AIM of this study was to estimate the prevalence rates of low back pain (LBP), cervicobrachial and lumbosacral radicular syndromes (CBR and LSRS) in workers from a fertilizer plant and also to analyze the impact of several important work-related and non-occupational risk factors. SUBJECTS of this comprehensive cross-sectional study were 898 workers and employees from the four main departments of the plant. The following complex of methods was applied: neurologic history, complete neurologic status and statistical method.

RESULTS

Age is the first risk factor, discussed by authors. The data showed highly significant differences in the prevalence of CBS-16.2% in the risk group vs. 10.0% in the referent group (OR 1.73, 95% CI 1.14-2.63); LBP-25.8% vs. 17.0% (OR 1.70, 95% CI 1.21-2.38) and LSRS-16.0% vs. 5.8% (OR 3.09, 95% CI 1.89-5.08). Gender is the second risk factor strongly related to LBP, CBS and LSRS. The prevalence of radicular syndromes is higher for women that for men: OR for CBS is 3.27 and 1.93 for LSRS. There is an interesting trend in the case of combined impact of age and gender among men and women of 40 or under and over 40--the risk, estimated by OR, is higher. In men over 40, overweight, obesity and heaviness of smoking, estimated by duration of smoking and daily cigarette consumption (more than 20 years and more than 20 cigarettes per day), increase the risk of developing back disorders (BD). At this stage of the research, there is no proof of the impact of hypercholesterolemia, non-occupational or work-related strain on the development of BD. The authors' CONCLUSION is that these results may support programs for health promotion and health prevention.