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Signs of Continuous Disease Activity

Gholam H. Pezeshkpour, MD; Marinos C. Dalakas, MD

Arch Neurol. 1988;45(5):505-508.

Abstract
• In a retrospective study, we reviewed sections from the spinal cords from eight patients, aged 36 to 61 years, who had had poliomyelitis and who died of nonneurologic diseases nine months to 44 years (mean, 20.7 years) after the acute poliomyelitis infection. Five patients had stable postpoliomyelitis deficits without new symptoms, and three patients had new slowly progressive muscle weakness defined as postpoliomyelitis progressive muscular atrophy (PPMA). Representative spinal cord sections matched the patients' clinical involvement in both groups. Control tissues from ten patients with amyotrophic lateral sclerosis and five with spinocerebellar degeneration were examined simultaneously. The spinal cord segments from all patients who had had poliomyelitis showed loss or atrophy of motor neurons, severe reactive gliosis (disproportional to the neuronal loss), and a surprising mild to moderate perivascular and interparenchymal inflammation. There was no difference in these pathologic changes between the patients with stable postpoliomyelitis deficits and those with PPMA. Additional findings were axonal spheroids (dystrophic axons) and occasional chromatolytic neurons in the spinal cord of patients with PPMA. Corticospinal tracts were spared.

Author Affiliations
From the Neuromuscular Pathology Division, Armed Forces Institute of Pathology, Washington, DC (Dr Pezeshkpour); and the National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health, Bethesda, Md (Dr Dalakas).

Footnotes
Accepted for publication Oct 8, 1987.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as representing the views of the Department of the Army, the Department of the Air Force, or the Department of Defense.

Reprint requests to National Institutes of Neurological and Communicative Disorders and Stroke, Bldg 10, Room 5N226, Bethesda, MD 20892 (Dr Dalakas).

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ABSTRACT