Overwork weakness with evidence of muscle damage in a patient with residual paralysis from polio

Overwork weakness has been reported in survivors of poliomyelitis with residual paralysis. Investigators have recently reported that approximately 25% of polio survivors experience functional declines with onset of symptoms of new weakness, fatigue, and muscle pain. The diagnosis of overwork weakness has remained a clinical diagnosis, as previous investigations have failed to uncover reliable, objective, diagnostic methods to confirm the diagnosis in symptomatic individuals. A case is presented in which markedly elevated levels of CPK were present with symptoms of weakness, fatigue, and muscle pain. These levels declined after clinical intervention, with resolution of symptoms. This case represents an overuse syndrome in which muscle fibers were being damaged through overuse. This case further suggests the possible role of serum CPK in the diagnosis of, and in monitoring clinical intervention in, some polio survivors who experience overwork weakness.