This study aims to assess national trends in paralytic syndrome-related mortality in the United States from 1999 to 2023, stratified by age, sex, race/ethnicity, region, and urbanization status.

Paralytic syndromes include a broad range of neurological disorders that cause muscle weakness or paralysis due to damage or dysfunction of the upper or lower motor neurons. Despite advances in neurocritical care and rehabilitation, population-level data on mortality trends associated with paralytic syndromes remain limited.

From 1999 to 2023, paralytic syndromes caused 202,915 deaths among adults aged ≥25 years. The overall AAMR remained stable from 4.88 to 4.59 (AAPC: 0.04; 95% CI: -0.97 to 1.08). Men consistently had higher AAMRs than women throughout the study period. AAMRs increased from 1999 to 2023, among NH Blacks (7.07 to 7.42), and Hispanics (3.91 to 4.25). In contrast, AAMRs declined among NH Whites (4.72 to 4.4), NH Asians (4.42 to 2.98), and NH American Indians (6.99 to 4.78). Regionally, increases were noted in the South and West, while declines were noted in Northeast and Midwest. Non-metropolitan areas had higher mortality than metropolitan areas.

Paralytic syndrome-related mortality in the United States has remained largely stable over the past two decades, yet significant demographic and geographic disparities persist. Higher mortality among men, minority populations, and residents of rural regions underscores the need for targeted prevention strategies, improved access to neurological care, and further investigation into underlying social and clinical determinants of high mortality.