Muscle weakness and Neuropathy: Difference between revisions

Latest revision as of 22:48, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis of Muscle weakness and Neuropathy

Organ system	Disease	Symptoms												History	Physical Examination	Diagnosis
Organ system	Disease	Age of onset	Muscle weakness	Fever	Myalgia	Contractures	Gait abnormality	Neuropathy	Atrophy	Stiffness	Myoglobinuria	Other features	Laboratory Findings	History	Physical Examination	Creatine Kinase	Muscle Biopsy	Electromyogram
Medication−induced	Alcohol^[1]	Variable	Proximal	−	−	−	+	+/−	−	−	−	Swelling Tender Erythema and induration	Alcohol intoxication	Change in mental status Telangiectasia Peripheral neuropathy	Monspecific and are normal in many patients	Normal or ↑↑	Normal	Normal
Endocrine	Diabetic infraction^[2]	45	Proximal	+	+	−	−	+	+	−	−	Cramps Sudden onset of pain Anterior thigh muscles are most commonly involved	H/O long standing diabetes	Swelling Tenderness	Elevated ESR Leukocytosis	Normal	Necrosis Edema	Normal
Inflammatory/ Rheumatologic	Fibromyalgia^[3]	40−50s	Generalized	−	−	−	−	+	−	−	−	Anxiety or depression features Fatigue Sleep disturbance Numbness Muscle spasms	History of depression	Tenderness in the soft tissue anatomical location	Normal	Normal	Normal	Normal
Organ system	Disease	Age of onset	Muscle weakness	Fever	Myalgia	Contractures	Gait abnormality	Neuropathy	Atrophy	Stiffness	Myoglobinuria	Other features	History	Physical Examination	Laboratory Findings	Creatine Kinase	Muscle Biopsy	Electromyogram
Infectious	Lyme disease^[4]	Variable	Proximal	+	+	−	+/−	+	−	−	−	Erythema Migrans Flu−like symptoms Lyme arthritis Neurological manifestations	H/o tick bite Hiking trip	Target−like lesions HSM	Clinical diagnosis +Serology	N/A	N/A	N/A
	Polio^[5]	<5 yrs	Proximal	−	−	−	+	+	+	−	−	Asymmetrical paralysis Muscle atrophy Tremors Skeletal deformities	History of skipped immunization.	Normal Meningeal signs Asymmetrical flaccid paralysis Pharyngeal paralysis	Isolation from pharyngealsecretions, CSF Positive serology	N/A	N/A	Neurological pattern
	Syphilis^[6]	Variable	Negative	−	−	−	+	+	−	−	−	Chancre Lymphadenopathy Condylomata lata Neuro syphilis Cardiovascular syphilis	History of risk factors (MSM, unprotected sex, multiple sex partners)	Non−tender chancre in primary syphilis. Followed by rash Generalized lymphadenopathy in secondary syphilis	Darkfield examinations VDRL RPR FTA−ABS	N/A	N/A	N/A
Organ system	Disease	Age of onset	Muscle weakness	Fever	Myalgia	Contractures	Gait abnormality	Neuropathy	Atrophy	Stiffness	Myoglobinuria	Other features	History	Physical Examination	Laboratory Findings	Creatine Kinase	Muscle Biopsy	Electromyogram
Neurologic	ALS^[7]	>35	Proximal & Distal Distal	−	−	−	−	+	+	+	−	Dysphagia Spasticity Hyperreflexia Babinski's +	N/A	Both upper and lower motor neuron signs	Clinical diagnosis	Normal	Nonspecific findings of chronic denervation with reinnervation	Neuropathic
	Stroke^[8]	>65	Proximal & distal	−	−	−	+	+	+	−	−	Dysphagia Unilateral/Bilateral weakness	H/o HTN, dyslipidaemia DM	Weakness of the involved arm	Head CT	Normal	Normal	Neuropathic
	Multiple Sclerosis^[9]	30's	Proximal & distal	−	−	−	+	+	−	−	−	Ocular findings Urinary incontinence Problems with speech or swallowing	Attacks or exacerbation	Localized weakness Focal sensory disturbances Hyper reactive reflexes Increased tone or stiffness	Head CT ologo−clonal bands	Normal	N/A	Neuropathic

References

↑ Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ (November 2001). "Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis". Eur. J. Neurol. 8 (6): 677–87. PMID 11784353.
↑ Horton WB, Taylor JS, Ragland TJ, Subauste AR (2015). "Diabetic muscle infarction: a systematic review". BMJ Open Diabetes Res Care. 3 (1): e000082. doi:10.1136/bmjdrc-2015-000082. PMC 4410119. PMID 25932331.
↑ Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). "Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism". Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.
↑ Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M (August 1989). "Myositis during Borrelia burgdorferi infection (Lyme disease)". J. Neurol. Neurosurg. Psychiatry. 52 (8): 1002–5. PMC 1031843. PMID 2795056.
↑ Howard RS (June 2005). "Poliomyelitis and the postpolio syndrome". BMJ. 330 (7503): 1314–8. doi:10.1136/bmj.330.7503.1314. PMC 558211. PMID 15933355.
↑ French P (January 2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
↑ Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A (2015). "A comprehensive review of amyotrophic lateral sclerosis". Surg Neurol Int. 6: 171. doi:10.4103/2152-7806.169561. PMC 4653353. PMID 26629397.
↑ Baldwin K, Orr S, Briand M, Piazza C, Veydt A, McCoy S (May 2010). "Acute ischemic stroke update". Pharmacotherapy. 30 (5): 493–514. doi:10.1592/phco.30.5.493. PMID 20412000.
↑ Goldenberg MM (March 2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.

[pmid11784353-1] Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ (November 2001). "Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis". Eur. J. Neurol. 8 (6): 677–87. PMID 11784353.

[pmid25932331-2] Horton WB, Taylor JS, Ragland TJ, Subauste AR (2015). "Diabetic muscle infarction: a systematic review". BMJ Open Diabetes Res Care. 3 (1): e000082. doi:10.1136/bmjdrc-2015-000082. PMC 4410119. PMID 25932331.

[pmid27803417-3] Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). "Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism". Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.

[pmid2795056-4] Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M (August 1989). "Myositis during Borrelia burgdorferi infection (Lyme disease)". J. Neurol. Neurosurg. Psychiatry. 52 (8): 1002–5. PMC 1031843. PMID 2795056.

[pmid15933355-5] Howard RS (June 2005). "Poliomyelitis and the postpolio syndrome". BMJ. 330 (7503): 1314–8. doi:10.1136/bmj.330.7503.1314. PMC 558211. PMID 15933355.

[pmid17235095-6] French P (January 2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.

[pmid26629397-7] Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A (2015). "A comprehensive review of amyotrophic lateral sclerosis". Surg Neurol Int. 6: 171. doi:10.4103/2152-7806.169561. PMC 4653353. PMID 26629397.

[pmid20412000-8] Baldwin K, Orr S, Briand M, Piazza C, Veydt A, McCoy S (May 2010). "Acute ischemic stroke update". Pharmacotherapy. 30 (5): 493–514. doi:10.1592/phco.30.5.493. PMID 20412000.

[pmid22605909-9] Goldenberg MM (March 2012). "Multiple sclerosis review". P T. 37 (3): 175–84. PMC 3351877. PMID 22605909.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

@@ Line 1: / Line 1: @@
-[[Dexamethasone suppression test|<nowiki/>]]
+{{CMG}}
+==Differential Diagnosis of Muscle weakness and Neuropathy==
 {|
 ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
@@ Line 25: / Line 28: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
 |-
-!Medication−induced
+! style="background:#4479BA; color: #FFFFFF;" align="center" + |Medication−induced
 ! style="background:#DCDCDC;" align="center" + |[[Alcohol]]<ref name="pmid11784353">{{cite journal |vauthors=Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ |title=Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis |journal=Eur. J. Neurol. |volume=8 |issue=6 |pages=677–87 |date=November 2001 |pmid=11784353 |doi= |url=}}</ref>
 | style="background:#F5F5F5;" align="center" + |Variable
@@ Line 56: / Line 59: @@
 * Normal
 |-
-!Endocrine
+! style="background:#4479BA; color: #FFFFFF;" align="center" + |Endocrine
 ! style="background:#DCDCDC;" align="center" + |Diabetic infraction<ref name="pmid25932331">{{cite journal |vauthors=Horton WB, Taylor JS, Ragland TJ, Subauste AR |title=Diabetic muscle infarction: a systematic review |journal=BMJ Open Diabetes Res Care |volume=3 |issue=1 |pages=e000082 |date=2015 |pmid=25932331 |pmc=4410119 |doi=10.1136/bmjdrc-2015-000082 |url=}}</ref>
 | style="background:#F5F5F5;" align="center" + |45
@@ Line 88: / Line 91: @@
 * Normal
 |-
-!Inflammatory/ Rheumatologic
+! style="background:#4479BA; color: #FFFFFF;" align="center" + |Inflammatory/ Rheumatologic
 ! style="background:#DCDCDC;" align="center" + |[[Fibromyalgia]]<ref name="pmid27803417">{{cite journal |vauthors=Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H |title=Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism |journal=Intern. Med. |volume=55 |issue=21 |pages=3185–3190 |date=2016 |pmid=27803417 |pmc=5140872 |doi=10.2169/internalmedicine.55.5926 |url=}}</ref>
 | style="background:#F5F5F5;" align="center" + |40−50s
@@ Line 140: / Line 143: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
 |-
-! rowspan="3" style="background:#DCDCDC;" align="center" + |Infectious
+! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Infectious
 ! style="background:#DCDCDC;" align="center" + |[[Lyme disease]]<ref name="pmid2795056">{{cite journal |vauthors=Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M |title=Myositis during Borrelia burgdorferi infection (Lyme disease) |journal=J. Neurol. Neurosurg. Psychiatry |volume=52 |issue=8 |pages=1002–5 |date=August 1989 |pmid=2795056 |pmc=1031843 |doi= |url=}}</ref>
 | style="background:#F5F5F5;" align="center" + |Variable
@@ Line 262: / Line 265: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
 |-
-! rowspan="3" style="background:#DCDCDC;" align="center" + |Neurologic
+! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Neurologic
 ! style="background:#DCDCDC;" align="center" + |[[Amyotrophic lateral sclerosis|ALS]]<ref name="pmid26629397">{{cite journal |vauthors=Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A |title=A comprehensive review of amyotrophic lateral sclerosis |journal=Surg Neurol Int |volume=6 |issue= |pages=171 |date=2015 |pmid=26629397 |pmc=4653353 |doi=10.4103/2152-7806.169561 |url=}}</ref>
 | style="background:#F5F5F5;" align="center" + |>35
@@ Line 351: / Line 354: @@
 * Neuropathic
 |}
-<references />
+==References==
+{{Reflist|2}}
+[[Category:Medicine]]
+[[Category:Neurology]]
+[[Category:Rheumatology]]
+[[Category:Up-To-Date]]

Muscle weakness and Neuropathy: Difference between revisions

Latest revision as of 22:48, 29 July 2020

Differential Diagnosis of Muscle weakness and Neuropathy

References

Navigation menu

Search