{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T16:39:13Z","timestamp":1789922353859,"version":"4.0.1"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health-National Institute of Alcohol Abuse and Alcoholism","award":["AA-011431"],"award-info":[{"award-number":["AA-011431"]}]},{"name":"National Institutes of Health-National Institute of Alcohol Abuse and Alcoholism","award":["AA-024018"],"award-info":[{"award-number":["AA-024018"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Post-polio syndrome (PPS) is characterized by recrudescence or worsening of motor neuron disease symptoms decades after recovery from acute paralytic poliovirus infection, i.e., poliomyelitis. PPS afflicts between 25% and 40% of poliomyelitis survivors and mimics motor neuron diseases (MNDs), such as amyotrophic lateral sclerosis (ALS), due to its selective impairment, degeneration, or death of motor neurons in the brainstem and spinal cord. Herein, we report a case of PPS in a 68-year-old man with a remote history of bulbar and cervical cord involvement by poliomyelitis, review the relevant literature, and contrast the salient histopathologic features that distinguish our case of PPS from ALS.<\/jats:p>","DOI":"10.3390\/neurolint15020035","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T02:28:12Z","timestamp":1681439292000},"page":"569-579","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Post-Polio Syndrome Revisited"],"prefix":"10.3390","volume":"15","author":[{"given":"Michael","family":"Punsoni","sequence":"first","affiliation":[{"name":"Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelli S.","family":"Lakis","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Mellion","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"de la Monte","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, Departments of Pathology and Laboratory Medicine, Neurology, and Neurosurgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/oxfordjournals.aje.a112848","article-title":"The epidemiology of poliomyelitis: Enigmas surrounding its appearance, epidemicity, and disappearance","volume":"110","author":"Nathanson","year":"1979","journal-title":"Am. J. Epidemiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/aje\/kwq320","article-title":"From emergence to eradication: The epidemiology of poliomyelitis deconstructed","volume":"172","author":"Nathanson","year":"2010","journal-title":"Am. J. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.idc.2015.07.003","article-title":"The Challenge of Global Poliomyelitis Eradication","volume":"29","author":"Garon","year":"2015","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/S1473-3099(15)00008-0","article-title":"Overcoming barriers to polio eradication in conflict areas","volume":"15","author":"Garon","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.virusres.2005.04.008","article-title":"Poliovirus and poliomyelitis: A tale of guts, brains, and an accidental event","volume":"111","author":"Mueller","year":"2005","journal-title":"Virus Res."},{"key":"ref_6","first-page":"81","article-title":"Poliomyelitis: Problems in pathogenesis and immunization","volume":"30","author":"Horstmann","year":"1957","journal-title":"Yale J. Biol. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1126\/science.123.3209.1151","article-title":"Pathogenesis of poliomyelitis; reappraisal in the light of new data","volume":"123","author":"Sabin","year":"1956","journal-title":"Science"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1093\/aje\/136.7.769","article-title":"Epidemiology of the post-polio syndrome","volume":"136","author":"Ramlow","year":"1992","journal-title":"Am. J. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"447","DOI":"10.47102\/annals-acadmedsg.V34N7p447","article-title":"Post-poliomyelitis syndrome: Case report and review of the literature","volume":"34","author":"Lin","year":"2005","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/01.NURSE.0000392917.84035.be","article-title":"Post-polio syndrome: Unraveling the mystery","volume":"41","author":"LaRocco","year":"2011","journal-title":"Nursing"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"357","DOI":"10.5114\/ninp.2012.30269","article-title":"Post-polio syndrome. Part I. The \u201clegacy\u201d of forgotten disease, challenges for professionals and polio survivors","volume":"46","author":"Matyja","year":"2012","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_12","first-page":"V05140291","article-title":"Polio, late effects and post-polio","volume":"176","author":"Kay","year":"2014","journal-title":"Ugeskr. Laeger."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.pjnns.2017.01.009","article-title":"Post-polio syndrome. Cases report and review of literature","volume":"51","author":"Pastuszak","year":"2017","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1002\/mus.26167","article-title":"Post-polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis","volume":"58","author":"Lo","year":"2018","journal-title":"Muscle Nerve"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00401-014-1277-z","article-title":"FTLD-ALS of TDP-43 type and SCA2 in a family with a full ataxin-2 polyglutamine expansion","volume":"128","author":"Baumer","year":"2014","journal-title":"Acta. Neuropathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/0141076813511451","article-title":"Advances in motor neurone disease","volume":"107","author":"Baumer","year":"2014","journal-title":"J. R. Soc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3109\/17482968.2012.690419","article-title":"The natural history of motor neuron disease: Assessing the impact of specialist care","volume":"14","author":"Aridegbe","year":"2013","journal-title":"Amyotroph. Lateral. Scler. Frontotemporal. Degener."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/B978-0-12-802973-2.00013-6","article-title":"The epidemiology of amyotrophic lateral sclerosis","volume":"138","author":"Talbott","year":"2016","journal-title":"Handb. Clin. Neurol."},{"key":"ref_19","unstructured":"National Institute on Aging and Alzheimer\u2019s Association (2023, February 15). Alzheimer\u2019s Disease and Related Dementias. Basics of Alzheimer\u2019s Disease and Dementia, Available online: https:\/\/www.nia.nih.gov\/health\/alzheimers-disease-fact-sheet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1017\/cjn.2016.2","article-title":"The Prevalence and Incidence of Dementia with Lewy Bodies: A Systematic Review","volume":"43","author":"Hogan","year":"2016","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1212\/01.WNL.0000078928.20107.52","article-title":"Survival in frontotemporal dementia","volume":"61","author":"Hodges","year":"2003","journal-title":"Neurology"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wang, S., Li, T., Zhou, T., Pu, L., Wang, H.Y., Yin, X., Hao, X., Ren, L., and Liang, Z. (2022). Survival in patients with Parkinson\u2019s disease: A ten-year follow-up study in northern China. BMC Neurol., 22.","DOI":"10.1186\/s12883-022-02899-5"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/jnnp.67.3.300","article-title":"The sydney multicentre study of Parkinson\u2019s disease: Progression and mortality at 10 years","volume":"67","author":"Hely","year":"1999","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1111\/ene.14393","article-title":"Amyotrophic lateral sclerosis: A clinical review","volume":"27","author":"Masrori","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/j.1749-6632.1995.tb27532.x","article-title":"The post-polio syndrome as an evolved clinical entity. Definition and clinical description","volume":"753","author":"Dalakas","year":"1995","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1056\/NEJM198604103141505","article-title":"A long-term follow-up study of patients with post-poliomyelitis neuromuscular symptoms","volume":"314","author":"Dalakas","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_27","unstructured":"Plum, F. (1988). Advances in Contemporary Neurology, F.A. Davis."},{"key":"ref_28","unstructured":"Munsat, T.L. (1990). The Post-Polio Syndrome, Butterworth Heinemann."},{"key":"ref_29","unstructured":"Simionuscu, L., and Modlin, J.F. (2023, February 15). Poliomyelitis and Post-Polio Syndrome. Available online: https:\/\/www.uptodate.com\/contents\/poliomyelitis-and-post-polio-syndrome\/print."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1749-6632.1995.tb27543.x","article-title":"Pathogenetic mechanisms of post-polio syndrome: Morphological, electrophysiological, virological, and immunological correlations","volume":"753","author":"Dalakas","year":"1995","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"66S","DOI":"10.1016\/S0002-9343(98)00161-2","article-title":"Parallels between post-polio fatigue and chronic fatigue syndrome: A common pathophysiology?","volume":"105","author":"Bruno","year":"1998","journal-title":"Am. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.rehab.2012.08.006","article-title":"Life satisfaction and self-reported impairments in persons with late effects of polio","volume":"55","author":"Lexell","year":"2012","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/mus.20259","article-title":"Post-poliomyelitis syndrome","volume":"31","author":"Trojan","year":"2005","journal-title":"Muscle Nerve"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1056\/NEJM197808172990704","article-title":"The autopsy: Its decline and a suggestion for its revival","volume":"299","author":"Roberts","year":"1978","journal-title":"N. Engl. J. Med."},{"key":"ref_35","first-page":"563","article-title":"Histopathologic basis of clinical findings in poliomyelitis","volume":"6","author":"Bodian","year":"1949","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kumar, V., Kim, S.H., and Bishayee, K. (2022). Dysfunctional Glucose Metabolism in Alzheimer\u2019s Disease Onset and Potential Pharmacological Interventions. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23179540"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3575","DOI":"10.1002\/cphy.c210034","article-title":"Physiological Systems in Promoting Frailty","volume":"12","author":"Perazza","year":"2022","journal-title":"Compr. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Barbalho, S.M., Direito, R., Laurindo, L.F., Marton, L.T., Guiguer, E.L., Goulart, R.A., Tofano, R.J., Carvalho, A.C.A., Flato, U.A.P., and Capelluppi Tofano, V.A. (2022). Ginkgo biloba in the Aging Process: A Narrative Review. Antioxidants, 11.","DOI":"10.3390\/antiox11030525"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1212\/01.wnl.0000237342.73436.f6","article-title":"The challenge of diagnosing ALS in patients with prior poliomyelitis","volume":"67","author":"Salajegheh","year":"2006","journal-title":"Neurology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s004010050991","article-title":"Amyotrophic lateral sclerosis in an adult following acute paralytic poliomyelitis in early childhood","volume":"97","author":"Shimada","year":"1999","journal-title":"Acta Neuropathol."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/15\/2\/35\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:15:42Z","timestamp":1760123742000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/15\/2\/35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["neurolint15020035"],"URL":"https:\/\/doi.org\/10.3390\/neurolint15020035","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]}}}