Topics Discussed: musculoskeletal system; neurology; neuromuscular weakness.
Sections: Weakness: Introduction, Pathophysiology, Diagnosis, Specific Causes of Weakness, Disposition, References.
- Upper motor neuron diseases usually present with asymmetrical weakness contralateral to the lesion. Lower motor neuron diseases present with symmetrical weakness that can be isolated to specific muscle groups.
- Involvement of bulbar muscles is manifested by cranial nerve findings, facial muscle weakness, and chewing or swallowing difficulties. Bulbar involvement can occur in both upper and lower motor neuron disorders.
- Neuropathies are disorders of nerves and tend to cause distal muscle weakness, hypesthesias or paresthesias, and decreased reflexes, especially early in the disease.
- Myopathies are disorders of muscle and can be inflammatory or congenital. Inflammatory myopathies usually involve proximal muscles and are associated with muscle pain or tenderness.
- GuillainBarré syndrome often starts with nonspecific muscular pain, most often in the thighs. The pain is followed by weakness, which is most often symmetrical and distal, progresses upward, and, in some cases, results in total paralysis within 24 hours.
- Transverse myelitis is a syndrome characterized by acute dysfunction at a level of the spinal cord. A mass lesion must be emergently excluded.
- Tick paralysis is caused by a neurotoxin from the Rocky Mountain wood tick or the Eastern dog tick.
- Food-borne botulism results from ingestion of toxins contained in improperly canned foods. Diarrhea and vomiting are..."
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