Diagnostic Post Test
Diagnostic Post Test
How do doctors distinguish Post Polio Syndrome from Multiple System Atrophy as a diagnosis?
Are the symptoms similar? Is there a diagnostic test to make a determination?
Yes, this is a elderly female patient who started showing first symptoms after surgery 4 years ago. She had Polio when she was younger.
These are markedly different syndromes. Post-polio is manifest by weakness in a lower motor neuron pattern, usually in the distribution of weakness seen in the original polio infection. MSA is predominantly parkinsonism and autonomic nervous system problems with orthostatic hypotension being prominent. No lab tests for either.
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I originally read MSA as "spinomuscular atrophy" and instead of deleting that answer I'll just leave it below but feel free to ignore this....
As a side note, SMA is much more similar to post-polio than is MSA.
The biggest factor is that there must be a history of polio in order to diagnose post-polio syndrome.
Differentiation is rarely an issue. You'd have to have awfully bad luck to have SMA and a history of polio because both are rare. In addition, there are essentially no new cases of polio in US so you'd have to have one of the adult-onset SMA's (even rarer),
Both cause lower motor neuron weakness without sensory problems so in that sense they are similar. Post-polio weakness tends to be most prominent in the distribution of the original areas of weakness where as SMA weakness is usually more widespread. Post-polio weakness may worsen for a time but then stabilizes while SMA is usually progressive.
There is no lab test for post-polio. Gene testing can be done for some of the SMA's.
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