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Post-polio syndrome presenting as isolated neck extensor myopathy: a case report

BACKGROUND: Post-polio syndrome (PPS) is characterized by new or worsening muscular weakness, atrophy, muscle and joint pain, and muscle fatiguability decades after paralytic poliomyelitis infection. CASE DESCRIPTION: A 56-year-old man was diagnosed with paralytic poliomyelitis at the age of five, w...

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Autores principales: Chu, Eric Chun-Pu, Zoubi, Fadi Al
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130685/
https://www.ncbi.nlm.nih.gov/pubmed/37122964
http://dx.doi.org/10.21037/acr-22-76
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author Chu, Eric Chun-Pu
Zoubi, Fadi Al
author_facet Chu, Eric Chun-Pu
Zoubi, Fadi Al
author_sort Chu, Eric Chun-Pu
collection PubMed
description BACKGROUND: Post-polio syndrome (PPS) is characterized by new or worsening muscular weakness, atrophy, muscle and joint pain, and muscle fatiguability decades after paralytic poliomyelitis infection. CASE DESCRIPTION: A 56-year-old man was diagnosed with paralytic poliomyelitis at the age of five, which left him with flaccid paralysis and weakness of the right leg. One year before seeking chiropractic care, the patient saw his primary care physician with neck pain, low back pain, and fatigue. At the time, he had been diagnosed with degenerative spondylosis and was being treated with tricyclic antidepressants, clonazepam, and tramadol. Despite taking the drugs, his spinal pain and fatigability deteriorated, and he acquired head ptosis during the following six months. As a result, he sought chiropractic care for second opinion. Due to the patient’s failure to respond to oral analgesics, radiographs were performed, which revealed degenerative spondylosis, cervical flexion deformity, right pelvic drop, and right thoracolumbar scoliosis. The patient met the PPS diagnostic criteria. PPS related isolated neck extensor myopathy (INEM) was impressed. Multimodal intervention including cervical and lumbar manipulation, spinal traction, micro-vibration deep muscle massage, and core muscle training was provided. As a result of 40-month treatment, the patient reported full resolution of physical complaints. Head posture restored, cervical curvature retrieved and pelvic obliquity relatively corrected. CONCLUSIONS: Survivors of paralytic polio are especially vulnerable to developing leg weakness and length discrepancy, pelvic obliquity, asymmetric axial loading, and trunk muscular imbalance. The current case demonstrates a rare myopathy in a patient at post-polio stage, as well as the restoration of neck function with chiropractic intervention.
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spelling pubmed-101306852023-04-27 Post-polio syndrome presenting as isolated neck extensor myopathy: a case report Chu, Eric Chun-Pu Zoubi, Fadi Al AME Case Rep Case Report BACKGROUND: Post-polio syndrome (PPS) is characterized by new or worsening muscular weakness, atrophy, muscle and joint pain, and muscle fatiguability decades after paralytic poliomyelitis infection. CASE DESCRIPTION: A 56-year-old man was diagnosed with paralytic poliomyelitis at the age of five, which left him with flaccid paralysis and weakness of the right leg. One year before seeking chiropractic care, the patient saw his primary care physician with neck pain, low back pain, and fatigue. At the time, he had been diagnosed with degenerative spondylosis and was being treated with tricyclic antidepressants, clonazepam, and tramadol. Despite taking the drugs, his spinal pain and fatigability deteriorated, and he acquired head ptosis during the following six months. As a result, he sought chiropractic care for second opinion. Due to the patient’s failure to respond to oral analgesics, radiographs were performed, which revealed degenerative spondylosis, cervical flexion deformity, right pelvic drop, and right thoracolumbar scoliosis. The patient met the PPS diagnostic criteria. PPS related isolated neck extensor myopathy (INEM) was impressed. Multimodal intervention including cervical and lumbar manipulation, spinal traction, micro-vibration deep muscle massage, and core muscle training was provided. As a result of 40-month treatment, the patient reported full resolution of physical complaints. Head posture restored, cervical curvature retrieved and pelvic obliquity relatively corrected. CONCLUSIONS: Survivors of paralytic polio are especially vulnerable to developing leg weakness and length discrepancy, pelvic obliquity, asymmetric axial loading, and trunk muscular imbalance. The current case demonstrates a rare myopathy in a patient at post-polio stage, as well as the restoration of neck function with chiropractic intervention. AME Publishing Company 2023-03-20 /pmc/articles/PMC10130685/ /pubmed/37122964 http://dx.doi.org/10.21037/acr-22-76 Text en 2023 AME Case Reports. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Case Report
Chu, Eric Chun-Pu
Zoubi, Fadi Al
Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title_full Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title_fullStr Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title_full_unstemmed Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title_short Post-polio syndrome presenting as isolated neck extensor myopathy: a case report
title_sort post-polio syndrome presenting as isolated neck extensor myopathy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130685/
https://www.ncbi.nlm.nih.gov/pubmed/37122964
http://dx.doi.org/10.21037/acr-22-76
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