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Fatigue, a common complaint in individuals with postpolio syndrome (PPS), is defined as an overwhelming sustained feeling of exhaustion and diminished capacity for physical and mental work. A comprehensive medical work-up is needed to rule out all other causes of fatigue. A sleep study should be considered for individuals with PPS who complain of fatigue. Self-reported outcome measures, such as the Fatigue Severity Scale, are reliable and valid tools to measure fatigue in this population. Fatigue management consists of individualized treatment of underlying medical conditions, energy conservation, pacing techniques, and lifestyle modifications.

Setting: Outpatient rehabilitation clinic. Patient: A 47-year-old man with a history of polio and paralysis of his right arm. Case Description: The patient complained of numbness and tingling in his left hand both with activity and at night. His 2-point discrimination was 3 to 4mm, grasp strength was 70lb, lateral pinch was 22lb, and tip pinch was 15lb. Nerve conduction studies (NCSs) revealed an absent left median sensory nerve action potential (SNAP) and a prolonged motor nerve action potential (MNAP) equal to 6.1ms with a normal amplitude. The patient refused electromyography and was diagnosed with median neuropathy at the wrist, which appeared to be severe given the limited testing. A surgical consultation was recommended, but the patient refused, and conservative treatment was initiated. Treatment included lifestyle modifications, anti-inflammatory medications, vitamin B supplements, and a nocturnal wrist splint. He also began to use voice-activated software, speakerphone, large grip pen, and reduced-tension car steering. Assessment/Results: A repeat NCS was done at 6-month follow-up and it showed significant improvement of his left median neuropathy. The SNAP was present but prolonged at 4.7ms (normal