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Distal muscle weakness differential diagnosis

The differential diagnosis of true muscle weakness is extensive, including neurologic, rheumatologic, endocrine, genetic, medication- or toxin-related, and infectious etiologies. A stepwise.. Differential Diagnosis Conditions that result in intrinsic weakness can be divided into several main categories: infectious, neurologic, endocrine, inflammatory, rheumatologic, genetic, metabolic,.. Distal myopathy (or distal muscular dystrophy) is a general term for a group of rare progressive genetic disorders characterized by wasting (atrophy) and weakness of the voluntary distal muscles. The distal muscles are those farther from the center of the body and include the muscles of the lower arms and legs and the hands and feet

Bilateral weakness of all four extremities (quadriparesis/plegia) Lesion: Cervical spinal cord Findings: UMN signs below level of injury, strength/sensory testing identifies level Bilateral weakness, proximal groups Lesion: Muscle Causes: Rhabdomyolysis, polymyositis, dermatomyositis, myopathie Weakness. Fasciculation. Tone. Summary. Recalling these findings can be simplified by understanding the underlying process. Denervation near the target muscle fibers (lower motor neuron disease) results in dampening of the efferent limb of spinal reflexes, resulting in hyporeflexia Muscle Fiber Activity Muscle Size Large Muscles Weakness > Wasting Wasting > Weakness Absent Pain Tendon Reflexes MRI: Acute Episodic Fatigue Myasthenia Onset of weakness Congenital Infantile Hereditary: SYSTEMIC FEATURES: LAB FEATURES GENERAL TOPICS: Amyloid Cardiac With Myopathy No myopathy Sudden Death CNS Endocrine Gastro-Intestinal Infection Evaluation of Weakness Evaluation of weakness should try to distinguish true muscular weakness from fatigue, then check for findings that help establish the location or mechanism (eg, whether weakness is caused by dysfunction of the brain, spinal cord, plexuses, peripheral nerves, neuromuscular junction, or muscles) and, when possible, the cause Diagnostic (Molecular) testing: When a pattern of disease and its tissue localization are identified other laboratory testing can be employed to make a specific diagnosis, guide consultation of the patient, and direct treatment. Diagnostic tests include: Muscle biopsy. Histochemistry: Diagnosis by specific morpholgic features.

Muscle Weakness in Adults: Evaluation and Differential

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy typically characterised by symmetrical involvement, and proximal as well as distal muscle weakness (typical CIDP). However, there are several 'atypical' subtypes, such as multifocal acquired demyelinating sensory and motor neuropathy (Lewis-Sumner syndrome) and 'distal acquired demyelinating. Differential diagnosis summary that will come in handy for clinical exam ISCE in fourth year. weakness unilateral lmn signs umn signs intracranial (hemisensor Recurring episodes of weakness should raise the question of periodic paralysis. Weakness exacerbated by effort and relieved by rest is characteristic of myasthenia gravis. Proximal muscle weakness suggests a myopathy, whereas distal muscle weakness is more consistent with a peripheral neuropathy or pyramidal tract disorder The differential diagnosis of weakness is extensive, and the signs and symptoms of inflammatory myopathy have significant overlap with other myopathies. Therefore, there will be times when the diagnosis remains elusive despite a thorough work-up. and early distal muscle weakness. In muscle biopsies, abnormal staining for the dystrophin. DIFFERENTIAL DIAGNOSIS WORKUPWORK UP OCT 2010 2. FASCICULATIONS Spontaneous, involuntary, irregular and painless twitching (contractions) of part of a muscle Presents with distal weakness

Differential Diagnosis of Calf Pain and Weakness: ~lexor Hahcis Longus Strain Paul D. Howard, PhD, P7; Cert MDT1 -- -*. - BACKGROUND Injuries of the flexor hallucis longus (FHL), such as tendinitis and partial rupture of the muscle belly, are most commonly reported in ballet dancers, but rare cases have been reported in other athletes.I7 In Involvement of proximal > distal musculature? Myopathy; Unilateral weakness: CVA, TIA; If non-neuromuscular weakness then BROAD differential, obtain: ECG, CBC, Chem10, LFTs, blood cultures, UA/urine culture, drug levels, CXR, Consider Head CT (focal deficit, altered, history of cancer, anticoagulation with minor trauma) Onset of weakness sudden. We report the case of a 33-year-old woman presenting with symmetrical upper and lower limb weakness, most severely affecting the distal muscle groups. After extensive neurological investigation including neurophysiology, muscle biopsy and genetic analysis, she was finally diagnosed with Nonaka myopathy and treated conservatively with physiotherapy In patients with muscle weakness that is atypical (ie, asymmetric or more distal), in whom it may be difficult to distinguish between a myopathic and neuropathic disorder causing weakness, an EMG and/or MRI should be performed before a muscle biopsy. If myopathy is suggested by EMG or MRI, muscle biopsy should then be performed The diagnosis is made on the basis of a history of a painful, tearing sensation in the antecubital region. Physical examination demonstrates a palpable and visible deformity of the distal biceps muscle belly with weakness in flexion and supination

Evaluation of the Patient with Muscle Weakness - American

  1. Weakness in the muscles of the face and tongue, resulting in difficulty speaking, swallowing, and smiling. Descending paralysis: Motor weakness that begins in the face and progressively moves down the body. Distal weakness: Weakness in the distal extremities (eg, foot drop). Hemiparesis: Weakness on one side of the body. Monoparesis: Weakness.
  2. ant feature than sensory symptoms. Reduced or absent deep tendon reflexes in upper and lower extremities. Elevated CSF protein without pleocytosis. Electrodiagnostic evidence of a demyelinating neuropathy
  3. ing the correct diagnosis. Many muscle diseases have features so characteristic that they can be diagnosed with relative certainty at the bedside. The results of laboratory studies, including creatine kinase, electrodiagnostic studies, muscle biopsy, and/or molec

The weakness of Guillain-Barré syndrome is more distal, and weakness in multiple sclerosis may be episodic and selective. Unlike childhood forms of SMA, adult SMA will not compromise respiratory function, but myasthenia gravis typically will. 4 Neuroimaging and electrodiagnostic testing are helpful in distinguishing these autoimmune diagnoses. This case report describes chronic polymyositis in an elderly woman in whom the weakness and wasting were confined almost entirely to the distal limb muscles. The diagnosis from distal muscular dystrophy of late onset is discussed. CASE HISTORY A 65-year-old woman presented with weakness of the left hand of 6 years' duration, and for 4 years. • Slowly progressive distal limb weakness begins in first dec-ade with great variation in onset; few sensory complaints. • Autosomal dominant, mutations commonly affect PMP22. • Neurological exam: Atrophy of distal leg muscles (stork leg appearance). Palpable nerve enlargement in 50%Palpable nerve enlargement in 50% Depending on the differential diagnosis and the patient comorbidities, additional studies may be needed. Neuromuscular junction disorders generally present with fati-gable proximal more than distal muscle weakness. In these circumstances, repetitive nerve stimulation studies of at least one distal and one proximal muscle should be performed Sarcopenia is the age-related loss of muscle mass and strength. Undiagnosed late-onset neuromuscular disorders need to be considered in the differential diagnosis of sarcopenia. Based on emblematic case reports and current neuromuscular diagnostic guidelines for three common late-onset neuromuscular disorders, a differential diagnostic approach for geriatric patients presenting with a.

proximal myopathy. Myopathy literally means muscle disease. Pattern of weakness in myopathy most commonly tends to involve proximal upper and/or lower limb muscles in a symmetrical fashion (hence, the prefix 'proximal'). Myopathy can also, less commonly, involve distal limb, neck, facial, ocular, pharyngeal, respiratory and cardiac musculature As ischemic foci are the most common finding, vasculitis is a differential diagnosis. Mihaljevic B, Sternic N, Skender Gazibara M, et al. Intravascular large B-cell lymphoma of central nervous system- a report of two cases and literature review. some muscle weakness possible in the distal lower extremities, including foot drop; reduced or. MRI can be useful in narrowing down the differential diagnosis based on muscles affected. 4,6 If a specific genetic cause is suspected, gene testing should be done before muscle biopsy. When choosing genes to test, careful consideration should be given to family history, ethnicity, age at onset, and clinical site of onset Lower motor neuron (LMN) syndromes typically present with muscle wasting and weakness and may arise from pathology affecting the distal motor nerve up to the level of the anterior horn cell. A variety of hereditary causes are recognised, including spinal muscular atrophy, distal hereditary motor neuropathy and LMN variants of familial motor neuron disease. Recent genetic advances have resulted. Disease/ Disorder Definition. Adult and adolescent onset muscular dystrophies (MDs) are a group of disorders that cause muscle disease (myopathy) characterized by progressive muscle weakness (myasthenia) and muscle degeneration (atrophy) due to mutations in one or more genes required for normal muscle function. 1 These mutations alter the function of proteins responsible for muscle structural.

Frontiers | Stepwise Approach to Myopathy in Systemic

Distal Myopathy - NORD (National Organization for Rare

Differential Diagnosis of Weaknes

Miyoshi myopathy is a type of muscular dystrophy characterized by muscle weakness and atrophy (wasting), mainly in the distal parts of the legs. The first symptoms typically begin in young adulthood (on average 20 years of age) and include weakness and atrophy of the calves (sometimes asymmetrically), leading to inability to jump, run or walk on tiptoes CIM is characterized by symmetric weakness, with proximal muscles being affected more than distal, flaccid muscle tone, and preserved sensation. 1,2. Etiology. While the exact etiology is unknown, most reported cases are multifactorial and usually involve prolonged intubation and the use of steroids and/or nondepolarizing neuromuscular blockade Weakness slowly progresses to all hand and lower leg muscles. In the lower limb, the anterior tibial muscle and toe extensors are typically affected leading to walking difficulties and steppage gait. Proximal limb muscles are only rarely involved. Muscle stretch reflexes are preserved (except ankle reflexes which may be lost later in the disease) History and neurologic examination — The diagnosis of CIDP should be considered in patients presenting with a progressive or relapsing-remitting polyneuropathy involving both motor and sensory axons along with areflexia, particularly when weakness predominates and affects proximal and distal muscles simultaneously and symmetrically. The.

Inflammatory Myopathies Difficult to Diagnose, Treat - The

Myopathy Differential Diagnosi

  1. distal myopathy and IBM can have 'neurogenic' features. Mis-diagnosis of MND in up to 13% of case.20 Key points Weak and wasted muscles with retained reflexes is highly suggestive of MND until proven otherwise. Consider the diagnosis when faced with progressive painless weakness in patients over the age of 50
  2. Search for: Rare Disease Profiles; 5 Facts; Rare IQ; Rare Mystery;
  3. ences) the expressed weakness of extensors and flexors of wrists and feet is being exposed

Pain in the extremities and muscle weakness were common clinical symptoms. Most patients also had cranial nerve impairment, hepatosplenomegaly, a waddling gait, and elevated serum alkaline phosphatase levels. Long bones were affected in all. We discuss the differential diagnosis for this interesting bone entity Additionally affecting distal muscle groups, making it hard to grip objects; Axial muscle weakness . Oropharyngeal muscle weakness leading to dysphagia [13] [14] Respiratory muscle weakness leading to restrictive lung disease; Cutaneous features [13] Cutaneous features are characteristic of dermatomyositis but may be found in other subtypes Nerve impingements are usually accompanied by EMG abnormalities, muscle weakness, and atrophy of muscles distally and proximally to piriformis, whereas piriformis syndrome typically exhibits weakness and atrophy only in distal musculature. The electrodiagnostic evaluation may show signs of dennervation in the muscles innervated by the sciatic. For distal symmetric muscle weakness, laboratory testing is an adjunct (B12, HgbA1c) to the primary diagnostic test, which is usually NCS and electromyography (EMG)

MYOPATHY Evaluation and Diagnosis- Kirsten Gruis, MD 2010 Page 5 of 19 1. In General Myopathy will result in symmetrical proximal limb weakness. Specific patterns of weakness: asymmetry, distal weakness, respiratory weakness and facial/ocular weakness narrow the differential diagnosis. 2. Facial/Ocular and Extraocular muscle weakness Differential Diagnosis of Progressive Generalized or Symmetrical Flaccid Paralysis EDWARD R. ISAACS, M.D some of the severely weakened distal muscles no com­ Oftentimes, pain precedes the weakness in af­ fected muscles, which usually involves the upper limbs first and especially proximal muscles and wris

Weakness - Neurologic Disorders - Merck Manuals

  1. The chapter concludes with an approach to the differential diagnosis of muscle weakness based on which muscle groups are weak, whether the muscle weakness is constant or fluctuating, and whether the disorder is genetic or acquired. In myopathic conditions in which proximal muscles are affected more than distal muscles, the extensor.
  2. Differential Diagnosis of Upper Extremity Disorders (Neck and Arm Pain) Laith Al-Shihabi, MD Howard S. An, MD Dr. An or an immediate family member has received royalties from U & I and Zimmer; serves as a paid consultant to Bioventis and Stryker; has stock or stock options held in Articular Engineering LLC, Medyssey, Spinal Kinetics
  3. ence. 13, 14, 17 The sensory distribution differences.

Further symptoms. Loss of at least the distal muscular proprioceptive reflexes (from distal to proximal), can be redeemable at the beginning of the disease. Relative symmetry of the muscle weakness. Cranial nerve deficits (mostly facial nerve), sensory deficits are rare. Recovery after a plateau phase of 1-4 weeks Proximal Muscle Weakness and Atrophy Symptom Checker: Possible causes include Distal Spinal Muscular Atrophy Type 1. Check the full list of possible causes and conditions now! Talk to our Chatbot to narrow down your search Ulnar nerve entrapment occurs when the ulnar nerve is compressed. This typically occurs at two main sites: the elbow and the wrist.Ulnar nerve entrapment at the elbow is usually at the cubital tunnel (Cubital Tunnel Syndrome).Ulnar nerve neuropathy at the elbow is the second most common entrapment neuropathy (the first most common is the median nerve at the wrist) Limb Girdle Muscular Dystrophy (LGMD) is not a single, but a rare group of inherited genetic disorders which are characterizes by progressive weakening of shoulder and hip muscles. LGMD is defined as a muscular dystrophy presenting with predominantly proximal weakness, sparing facial, extraocular, and distal extremity muscles (at least early in the course of the disease[1]

Start studying Differential Diagnosis of the Shoulder. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Muscle weakness with lifting and rotating Crepitus or crackling. Biceps tendinopathy. Distal Clavicle Osteolysis sx and tx Hereditary inclusion body myopathies (HIBM) are a group of rare genetic disorders which have different symptoms. Generally, they are neuromuscular disorders characterized by muscle weakness developing in young adults. Hereditary inclusion body myopathies comprise both autosomal recessive and autosomal dominant muscle disorders that have a variable expression in individuals, but all share. A reduction in the strength of one or more muscles. Definition (MSH) A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases Muscle weakness may spread from the proximal muscles to affect distal muscles. [rarediseases.org] In 4 of the 5 patients having a severe phenotype, symptoms appeared during infancy (2 to 3.5 years), with proximal muscle weakness predominating in the lower limbs and early [pediatricneurologybriefs.com Narrowing the differential diagnosis REVIEW ABSTRACT W Muscle weakness is a feature of numerous conditions, but the muscle weakness of inflammatory myopathies, especially polymyositis and dermatomyositis, is easy to differentiate by specific clinical, laboratory, electromyographic, and histological features. KEY POINT

Neuromuscular Disease: Typical Pattern

The MMT allows identification of weakness patterns (e.g., proximal, distal, axial) as well as combinations of individual muscle group involvement, thus constituting the first diagnostic step. However, there are numerous diseases with patterns of involvement that are very similar or indistinguishable from each other, so this part of the. Neurology - Differential Diagnosis UMN Lesion LMN lesion Increased tone Wasting and fasciculation Spasticity Decreased tone Weakness Weakness Brisk reflexes, extensor plantar response Reduced reflexes Proximal weakness CONGENITAL MIND → nor. mal sensation Congenital - mitochondrial M etabolic - Cushing's disease, hypothyroidism

Muscle lesions produce weakness with reduced tone. Reflexes are normal or reduced depending on severity. Anatomic Localization. Generalized motor disturbance has a broad differential diagnosis. In this case, differentiation between corticospinal, motor nerve, extrapyramidal, muscle, or neuromuscular junction narrows the diagnosis substantially Multiple muscle diseases can affect the same or similar sets of muscles, making it hard to perform a differential diagnosis. For example, there are several rare muscle diseases that largely affect the proximal muscles, those muscles that are closest to the core of your body, which can make them appear very similar and difficult to accurately. Muscle weakness can be a symptom of many chronic conditions and acute infections. It can also be a side effect of certain medications. Find out more about the causes of muscle weakness here ticity, weakness and muscle atrophy, and early death [11]. Beside the muscular involvement (Table 1), fas-ciculations, hyperreexia and elevated serum cre-atine kinase (CK) levels may be found [, 12, 13]. e 7 revised El-Escorial criteria (rEEC) (Table 2) are used for the diagnosis, although they only allow a diag

Proximal muscle weakness Practical Neurolog

  1. imal or absence of.
  2. Other patterns include scapuloperoneal weakness and distal weakness. A single genotype can present with different phenotypes. Conversely, a single phenotype can result from more than one genotype. There are some features that help to differentiate specific types of LGMD or at least narrow the differential diagnosis. Some distinguishing clinica
  3. imal distal muscle.
Limb Weakness II Osama SInflammatory Myopathy

Muscle weakness differential diagnosis - wikido

• Limb muscles weakness: - Initial symptoms in fewer than 10% - Upper extremities weakness is more common than lower extremities, asymmetrical - Involve proximal muscles than distal - Involve neck muscles: neck flexion weaker than neck extension Neurologic clinics 1997; JOAO 200 Proximal muscle weakness should therefore be considered a sensitive sign of CIDP (apart from distal, sensory and perhaps asymmetric variants), but with limited specificity considering disorders in the differential diagnosis of CIDP Five distinct predominant distal myopathies have been identified with discrete clinical and genetic patterns. Miyoshi myopathy (MM; early adult‑onset, type 2) is a subtype of dysferlinopathy. Furthermore, MM is the most common form of autosomal recessive distal myopathy. MM is typically characterized by muscular weakness, initially affecting the gastrocnemius or soleus muscle from the late. Differential diagnosis. 1. The possible differentials include. Distal form of spinal muscular atrophy: this is an extremely rare disorder, which presents in the adults and has a slow progression with almost no effect on the patients' lifespan Differential Diagnosis of Shoulder Pain Followed by Progressive Weakness: A Case Report 19 above 90 degrees elevation. Modalities (e.g., therapeu-tic ultrasound and electrical stimulation) were not uti-lized as there is no evidence supporting acceleration of axonal regeneration or gross muscle strength with ap-plication following PTS

Charcot-Marie-Tooth disease type 1A DNA test showing duplication in short arm of chromosome 17 (A); compared with normal (B). Nerve conduction study showing decreased nerve conduction velocity in median nerve in 18-year-old woman with Charcot-Marie-Tooth disease type 1. Cavovarus feet with heels visible from front (peekaboo sign) Such a combination of proximal and distal weakness is relatively unusual in most myopathies (obvious exceptions being myotonic dystrophy and facioscapulohumeral muscular dystrophy) including polymyositis, but can be seen in myofibrillar myopathies which are an important differential diagnosis to IBM

Clinical features and differential diagnosis of flail arm syndrome predominantly proximal weakness and atrophy of the upper symptoms were most frequently present either in distal muscles. My differential builds off of these two questions. The patient's symptoms suggest that I am well situated in a neurologic box of possible diagnoses. Listing causes of extremity weakness and numbness, I can begin with the central nervous system and move outward The OD's Guide to Ptosis Workup. Droopy eyelids can stem from a number of conditions. Differential diagnosis is key for these patients. This guide will help navigate those cases. By Eric Reinhard, OD, and Heather Spampinato, OD. P tosis, formally known as blepharoptosis, is a common finding characterized by upper eyelid drooping in primary gaze The classical clinical presentation in adulthood includes distal weakness, frontal balding, facial muscle weakness, cataracts, endocrinopathy, and cardiac dysfunction. 33 Myotonic dystrophy type I is an autosomal-dominant disorder, and diagnosis is established by identification of an expanded CTG trinucleotide repeat in DMPK Idiopathic inflammatory myopathies are a group of disorders characterized by inflammation of the skeletal muscles involved in movement, and usually appear in adults between age 40-60 and in children age 5-15, but can occur at any age. Idiopathic inflammatory myopathy manifests in several forms, including polymyositis (PM), dermatomyositis (DM.

Fatiguing maneuvers may be needed to elicit weakness in MG. Limb weakness in ALS can occur in any muscle group, but the most common presentation of limb weakness in ALS is asymmetric distal limb weakness, in the form of wasting in ulnar-innervated segments or with finger/wrist drop or even foot drop weakness over the past 8 months. Weakness began as a foot drop in the left lower extremity, and similar symptoms developed 2 months later in the right leg. The was no history of trauma, pain, paresthesia, or sensory loss. There were no complaints in the upper extremities. Family history is negative for others with muscle or nerve disorders

PPT - Carpal Tunnel Syndrome PowerPoint Presentation, free

Acute Non-Traumatic Weakness • LITFL • CCC Neurolog

Differential Diagnosis. Differential diagnosis of patients presenting with weakness in early infancy includes: Congenital myopathies - most common ones are central core, nemaline road, and centronuclear myopathy. These may also present secondary to metabolic disorders affecting the metabolism of carbohydrates, fats, and other molecules Inclusion body myositis (IBM) (/ m aɪ oʊ ˈ s aɪ t ɪ s /) (sometimes called sporadic inclusion body myositis, sIBM) is the most common inflammatory muscle disease in older adults. The disease is characterized by slowly progressive weakness and wasting of both proximal muscles (closest to the body's midline) and distal muscles (the limbs), most apparent in the finger flexors and knee extensors When muscle weakness is associated with pain, the first differential would be a traumatic or repetitive use strain (signaling possibly a grade I-III strain) or other condition originating from chronic muscle or tendon pathology (e.g. degenerative tendinopathy, myofibrosis o Polyneuropathy is a generalised disease of the peripheral nerves due to damage to the axon and/or the myelin sheath. Estimates on the prevalence in the general population range from 2% to 7%. Polyneuropathies are frequent neurological manifestations of systemic illnesses. For example, approximate..

Distal muscle weakness (Concept Id: C0427065

Proximal and distal motor strength should be preserved. Deep tendon reflexes (DTRs) DTRs should be symmetric in both legs. Loss of the patellar or Achilles reflex on the side of the sensory abnormality suggests an alternative diagnosis, for example femoral neuropathy or L3/L4 radiculopathy [See below for 'differential diagnosis' Both present with skeletal muscle weakness and myotonia, muscle pain, heart conduction defects, cataracts, testicular atrophy, and frontal balding. Electromyography may confirm myotonia that is not identified during clinical examination; however, genetic tests usually confirm the diagnosis. As no curative therapy exists, treatment is symptomatic Differential Diagnosis of the Cervical Spine: Spinal Masqueraders Ricky James Placide A multitude of pathologic conditions can affect the structure and function of the cervical spine, contributing to a variety of signs and symptoms. These conditions can be categorized as degenerative, traumatic, infectious, neoplastic, congenital, inflammatory, autoimmune, and vascular

Differential Diagnosis for Muscle Weakness - YouTub

Congenital hypomyelination neuropathy is a rare form of neonatal neuropathy that should be considered in the differential diagnosis of a newborn with profound hypotonia and weakness. It appears to be a heterogeneous disorder with some of the cases being caused by specific genetic mutations The differential diagnosis is broad and involves inflammatory diseases (including autoimmune and paraneoplastic causes), hereditary disorders, infection, toxicity, and ischemic and nutritional deficiencies. 5 Polyneuropathy can present in a distal-predominant, generalized or asymmetric pattern involving individual nerve trunks termed.

Chronic inflammatory demyelinating polyneuropathy: update

Peripheral neuropathy, in the broadest sense, refers to a range of clinical syndromes affecting a variety of peripheral nerve cells and fibers, including motor, sensory, and autonomic fibers ( Box 1 ). Most peripheral neuropathies affect all fiber types to some extent. However, a single fiber type may be predominantly or exclusively affected in. Weakness can vary from mild difficulty with walking to nearly complete paralysis of all extremity, facial, respiratory, and bulbar muscles. Differentiating Tests Albuminocytologic dissociation in cerebrospinal fluid (i.e., elevated protein with a normal WBC count), present in 80% to 90% of patients at 1 week after onset of symptoms Weakness and atrophy of the muscles of the distal extremities. Deformation of the limbs. Impaired sensitivity. Tendon hypo / areflexia. Coordination Disorders. This form of sensory neuropathy has a strong resemblance to other types of this disease, therefore it requires differentiation at the clinical level The consideration of the differential diagnosis in LOPD is crucial for a timely and accurate diagnosis because of the variability of symptoms, similarity of symptoms between LOPD and many other neuromuscular disorders, and the emergence in the literature of symptoms not usually associated with LOPD (rigid spine, basilar artery aneurysm, bulbar. Sensorimotor polyneuropathy is a bodywide (systemic) process that damages nerve cells, nerve fibers (axons), and nerve coverings ( myelin sheath). Damage to the covering of the nerve cell causes nerve signals to slow or stop. Damage to the nerve fiber or entire nerve cell can make the nerve stop working. Some neuropathies develop over years.

Limb Weakness Differential Diagnosis - StuDoc

Weakness, if present, is mild and usually restricted to the distal muscles, where muscle atrophy may also be observed. Severe or proximal weakness points to a different type of neuropathy (eg, polyradiculopathy), myopathy, or other neurologic diagnosis DISCUSSION. Hirayama disease, although a rare entity, should be part of the differential diagnosis for young male patients 11 complaining of upper extremity weakness associated with muscle wasting. Although familial presentations have been described, the disease is typically sporadic as in this case. 3,8,9 Because Hirayama disease is a rare disease, its etiology and pathophysiology are not.

Clinical Reasoning: Siblings with progressive weaknessSymptoms of high acetylcholineClinical Approach to Muscle Diseases