-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.