Pyridostigmine treatment of post‐polio syndrome fatigue: a single fibre EMG study

Abstract

Electrophysiological data suggest that impairment of neuromuscular junctions transmission (NMT) may be in part responsible for the fatigability affecting the majority of patients suffering with post‐poliomyelitic syndrome (PPS). The effect of the anticholinesterase medication pyridostigmine in PPS patients was evaluated by means of voluntary activation single fibre electromyography (VA‐SFEMG), a technique that is very sensitive in revealing neuromuscular transmission disturbances. Fourteen patients fulfilling the clinical criteria for PPS were included in the study. Muscle strength assessment and VA‐SFEMG were performed in basal conditions and 1 week after oral administration of pyridostigmine bromide (MESTINON) 60 mg tablet every 8 h. The treatment induced a statistically significant improvement of neuromuscular junction transmission in most PPS patients, including patients with only musculoskeletal symptoms and with post‐poliomyelitis progressive muscular atrophy. Pyridostigmine medication also produced an improvement of reported fatigue in about 70% of fatigued patients.