Polio Place

Post-Polio Health, Volume 29, Number 2, Spring 2013
Ask Dr. Maynard
Frederick M. Maynard, MD

Question: I am posting this question for my husband who had polio at age 2. He was affected quite seriously and was not able to stand on his own. He recovered completely, and now at age 52, is seeing signs of post-polio syndrome (PPS) that include weakness and atrophy of his thigh muscles.

While consulting a neurologist in India, it came up that the weakness should start in calf muscles first and affect those muscles more. While my husband has seen weakness in calf muscles, the atrophy in his thighs is more significant. Are there other reasons for this? Also, my husband got an EMT done in 2009 and the doctor is advising him to get another one. Is this necessary? We have to pay for all tests ourselves.

Answer: It is not unusual for later life weakening and atrophy (PPS) to occur in the thigh muscles and not the calf muscles, or be worse in the thigh muscles, which are the more impactful muscles to affect walking. This fact in itself should not drive one to be particularly concerned about a disease/diagnosis other than PPS.

I don’t know what an EMT test would be. Perhaps you meant an EMG, or electromyography? EMG is done with needle insertions into the muscle with a recording electrode and it provides information on the normal healthy functioning of the nerves and muscles, which can help explain why atrophy is occurring, including from PPS. If he had an EMG about three years ago, I would not think it necessary to repeat, unless it was entirely normal then, and yet the atrophy is progressing. Ask the doctor recommending it exactly why it is being recommended and how results would affect treatment.