French guidelines for post-polio syndrome and management of effects of aging in people with sequelae of acute anterior poliomyelitis

People with sequelae of acute anterior poliomyelitis (AAP) may develop secondary complications related to aging, as well as a specific complication of the disease known as post-polio syndrome (PPS). These complications are new neurological and musculoskeletal manifestations that occur after a prolonged period of disease stability. The onset is typically insidious and slow, but can be more rapid following a period of immobilization, surgery, or another intercurrent condition. The initial assessment may involve consulting a neurologist to rule out neurological diagnoses. Electroneuromyographic examination is a valuable tool for evaluating these patients. It is sometimes difficult to differentiate between the effects of aging in a person with sequelae of AAP and PPS, which is a distinct entity with specific diagnostic criteria. The rate at which muscle capacity declines, and its functional impact, can be a distinguishing factor. Subacute or rapid onset can be indicative of PPS. The emergence of new motor deficits in areas that were previously unaffected is also a strong argument for PPS. This neurological deterioration must be distinguished from musculoskeletal disorders associated with aging. Progression is usually slow and gradual, or occurs in stages with periods of stabilization. Physical and rehabilitation care is essential both in the initial assessment and for ongoing follow-up. There are no recommended medicinal treatments, especially no specific etiological treatment for PPS (such as immunoglobulins, corticosteroids, etc.) or effective symptomatic treatment for manifestations like fatigue or muscle weakness (e.g., pyridostigmine). Pain management should be regularly assessed; while drug treatments are not specific, non-pharmacological pain management through physical therapy is crucial. Particular attention should be paid to comorbidities, including excess weight and an increased risk of osteoporosis and fractures. Management should be multidisciplinary, with an annual review recommended. Follow-up will be adjusted based on the patient's preferences and needs, and monitoring will depend on the development of complications.

Published by Revue neurologique, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.neurol.2026.05.007