Parallels between post-polio fatigue & Chronic Fatigue Syndrome (CFS): a common pathophysiology

Fatigue is the most commonly reported and most debilitating of
post- polio sequelae affecting the >1.8 million North American
polio survivors. Post-polio fatigue is characterized by
subjective reports of difficulty with attention, cognition,
and maintaining wakefulness. These symptoms resemble those
reported in nearly 2 dozen outbreaks of post-viral fatigue
syndromes (PVFS) that have recurred during this century and
that are related clinically, historically, anatomically, or
physiologically to poliovirus infections. This article reviews
recent studies that relate the symptoms of post-polio fatigue
and chronic fatigue syndrome (CFS) to clinically significant
deficits on neuropsychologic tests of attention,
histopathologic and neuroradiologic evidence of brain lesions,
impaired activation of the hypothalamic-pituitary-adrenal
axis, increased prolactin secretion, and electroencephalogram
(EEG) slow-wave activity. A possible common pathophysiology
for post-polio fatigue and CFS, based on the Brain Fatigue
Generator Model of PVFS, and a possible pharmacotherapy for
PVFS based on replacement of depleted brain dopamine, will be
described.

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