Weakness, Daytime Somnolence, Cough, and Respiratory Distress in a 77-Year-Old Man With a History of Childhood Polio

A 77-year-old man presented with slowly progressive fatigue, muscle weakness, daytime somnolence, hoarseness, and wheezing. He noted also a chronic cough especially with the ingestion of food and liquid. These symptoms had accelerated over the last several years. Poliomyelitis was diagnosed at 11 years of age, but he never had required ventilatory support. The patient maintained an active business career up until the time of his most recent hospital admission. He was a current one-half pack per day cigarette smoker with a total of 50 pack-years.