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| Image = Muscle wasting in HIV.jpg| | | Image = Muscle wasting in HIV.jpg| |
| Caption = Muscle wasting in HIV. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>| | | Caption = Muscle wasting in HIV. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>| |
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| }} | | }} |
| {{SI}} | | {{Muscle weakness}} |
| {{CMG}}; '''Associate Editor(s)-In-Chief:''' {{MUT}} | | {{CMG}}; '''Associate Editor(s)-In-Chief:''' {{MUT}} |
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| ==Overview== | | ==[[Muscle weakness overview|Overview]]== |
| Muscle weakness (or "lack of strength") is a direct term for the inability to exert force with ones [[muscle]]s to the degree that would be expected given the individual's general [[physical fitness]]. A test of strength is often used during a [[diagnosis]] of a muscular disorder before the [[etiology]] can be identified. Such etiology depends on the type of muscle weakness, which can be true or perceived as well as variable topically. True weakness is substantial, while perceived rather is a sensation of having to put more effort to do the same task. On the other hand, various topic locations for muscle weakness are central, neural and peripheral. Central muscle weakness is an overall exhaustion of the whole body, while peripheral weakness is an exhaustion of individual muscles. Neural weakness are somewhere between. | |
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| Muscle weakness can be a result of vigorous [[Physical exercise|exercise]] but abnormal fatigue may be caused by barriers to or interference with the different stages of [[muscle contraction]]. | | ==[[Muscle weakness historical perspective|Historical Perspective]]== |
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| In a broader sense, muscle weakness is the physical part of [[fatigue (medical)]].
| | ==[[Muscle weakness classification|Classification]]== |
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| ==Classification== | | ==[[Muscle weakness pathophysiology|Pathophysiology]]== |
| ===True vs. Perceived===
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| The term subsumes two other more specific terms, ''true weakness'' and ''perceived weakness''.
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| * '''True weakness''' (or "objective weakness") describes a condition where the instantaneous force exerted by the muscles is less than would be expected. For instance, if a patient suffers from [[amyotrophic lateral sclerosis]] (ALS), [[motor neuron]]s are damaged and can no longer stimulate the muscles to exert normal force.
| | ==[[Muscle weakness causes|Causes]]== |
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| * '''Perceived weakness''' (or "subjective weakness") describes a condition where it seems to the patient that more effort than normal is required to exert a given amount of force.<ref>{{cite journal |author=Enoka RM, Stuart DG |title=Neurobiology of muscle fatigue |journal=J. Appl. Physiol. |volume=72 |issue=5 |pages=1631-48 |year=1992 |pmid=1601767 |doi=}}</ref> For instance, in some people with [[chronic fatigue syndrome]] (CFS) who may struggle to climb a set of stairs when feeling especially fatigued, their muscle strength when objectively measured (eg, the maximum weight they can press with their legs) is essentially normal, though this is not true for CFS patients who may be disabled through post-exertional weakness/malaise etc. and in severe cases may not be able to climb a flight of stairs.
| | ==[[Muscle weakness differential diagnosis|Differentiating Muscle Weakness from other Diseases]]== |
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| In some conditions, such as [[myasthenia gravis]] muscle strength is normal when resting, but ''true weakness'' occurs after the muscle has been subjected to exercise. This is also true for some cases of CFS, where objective post-exertion muscle weakness with delayed recovery time has been measured and is a feature of some of the published definitions. <ref>Paul L, Wood L, Behan WM, Maclaren WM; Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome. European Journal of Neurology 1999 Jan;6(1):63-69 PMID: 10209352</ref><ref>McCully K K, Natelson B H; Impaired oxygen delivery to muscle in chronic fatigue syndrome. Clinical Science 1999:97:603-608</ref><ref>Pascale De Becker, PhD; Johan Roeykens, PT; Masha Reynders, PT; Neil McGregor, MD, PhD; Exercise Capacity in Chronic Fatigue Syndrome. Archives of Internal Medicine Vol. 160 No. 21, November 27, 2000 </ref><ref>De Becker P, McGregor N, De Meirleir K. A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome. J Intern Med 2001;250:234-240.</ref><ref>Bruce M Carruthers, Anil Kumar Jain, Kenny L De Meirleir, Daniel L Peterson, Nancy G Klimas et al, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Guidelines, A Consensus Document Journal of Chronic Fatigue Syndrome 11(1):7-115, 2003. ISBN 0-7890-227-9</ref><ref>Jammes Y, Steinberg JG, Mambrini O, Bregeon F, Delliaux S; Chronic fatigue syndrome: assessment of increased oxidative stress and altered muscle excitability in response to incremental exercise. J Intern Med., 2005 Mar;257(3):299-310.</ref>
| | ==[[Muscle weakness epidemiology and demographics|Epidemiology and Demographics]]== |
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| In addition to true/perceived, muscle weaknes can also be central, neural and peripheral. Central muscle weakness manifests as an overall, bodily or systemic, sense of energy deprivation, and peripheral weakness manifests as a local, muscle-specific incapacity to do work. <ref>{{cite journal |author=Gandevia SC, Enoka RM, McComas AJ, Stuart DG, Thomas CK |title=Neurobiology of muscle fatigue. Advances and issues |journal=Adv. Exp. Med. Biol. |volume=384 |issue= |pages=515-25 |year=1995 |pmid=8585476 |doi=}}</ref><ref>{{cite journal |author=Kent-Braun JA |title=Central and peripheral contributions to muscle fatigue in humans during sustained maximal effort |journal=European journal of applied physiology and occupational physiology |volume=80 |issue=1 |pages=57-63 |year=1999 |pmid=10367724 |doi=}}</ref> Neural weakness can be both central and peripheral.
| | ==[[Muscle weakness risk factors|Risk Factors]]== |
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| ==Pathophysiology== | | ==[[Muscle weakness screening|Screening]]== |
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| ==Complete Differential Diagnosis of Causes of Muscle weakness== | | ==[[Muscle weakness natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| (In alphabetical order)
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| {{MultiCol}}
| | ==Diagnosis== |
| *[[3-Methylglutaconic aciduria]]
| | [[Muscle weakness history and symptoms|History and Symptoms]] | [[Muscle weakness physical examination|Physical Examination]] | [[Muscle weakness laboratory findings|Laboratory Findings]] | [[Muscle weakness electrocardiogram|Electrocardiogram]] | [[Muscle weakness chest x ray|Chest X Ray]] | [[Muscle weakness CT|CT]] | [[Muscle weakness MRI|MRI]] | [[Muscle weakness other imaging findings|Other Imaging Findings]] | [[Muscle weakness other diagnostic studies|Other Diagnostic Studies]] |
| *[[3-Quinuclidinyl benzilate]]
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| *[[Acamprosate ]]
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| *[[Accessory nerve disorder]]
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| *[[Acitretin ]]
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| *[[Acute intermittent porphyria]]
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| *Acute peripheral neuropathy
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| *[[Acute viral nasopharyngitis (common cold)]]
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| *[[Addison's disease]]
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| *[[Adrenal carcinoma]]
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| *[[Alcoholic polyneuropathy]]
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| *[[Aluminum Hydroxide ]]
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| *[[Amiloride and Hydrochlorothiazide ]]
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| *[[Amiodarone Oral ]]
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| *[[Amyotrophic lateral sclerosis]]
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| *[[Anorexia nervosa]]
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| *[[Arnold-Chiari malformation]]
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| *[[Arthrogryposis]]
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| *[[Autism]]
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| *[[Bassen-Kornzweig syndrome]]
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| *[[Becker's muscular dystrophy]]
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| *[[Beclomethasone Oral Inhalation ]]
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| *[[Benztropine Mesylate Oral ]]
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| *[[Bezafibrate ]]
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| *[[Botulism]]
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| *[[Brachial plexus injury]]
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| *[[Brompheniramine ]]
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| *[[Budesonide Inhalation Powder ]]
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| *[[Bulimia nervosa]]
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| *[[Cadmium poisoning]]
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| *[[Carnitine palmitoyltransferase I deficiency]]
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| *[[Chloroquine Phosphate Oral ]]
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| *[[Chlorothiazide ]]
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| *[[Chlorpheniramine ]]
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| *[[Chlorthalidone ]]
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| *[[Chronic fatigue syndrome]]
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| *[[Chronic inflammatory demyelinating polyneuropathy]]
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| *[[Ciclesonide Nasal Spray ]]
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| *[[Cirrhosis]]
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| *[[Clofibrate ]]
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| *[[Colistimethate Injection ]]
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| *[[Congenital muscular dystrophy]]
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| *[[Congenital myasthenic syndrome]]
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| *[[Congenital myopathy]]
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| *[[Connective tissue disease]]
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| *[[Cushing's syndrome]]
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| *[[Cyanocobalamin Injection ]]
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| *[[Cyproheptadine ]]
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| *[[Cytarabine ]]
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| *[[Daptomycin]]
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| *[[Decompression sickness]]
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| *[[Dejerine Sottas syndrome]]
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| *[[Dermatomyositis]]
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| *[[Desipramine ]]
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| *[[Devic's disease]]
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| *[[Dexamethasone Oral ]]
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| *[[Dextroamphetamine and Amphetamine ]]
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| *[[Diabetic amyotrophy]]
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| *[[Diabetic neuropathy]]
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| *[[Dicamba]]
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| *[[Dicyclomine ]]
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| *[[Diphenhydramine Oral ]]
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| *[[Donepezil ]]
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| *[[Dorzolamide and Timolol Ophthalmic ]]
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| *[[Doxazosin ]]
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| *[[Doxylamine ]]
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| *[[Duchenne muscular dystrophy]]
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| *[[Emery-Dreifuss Muscular Dystrophy]]
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| *[[Engelmann syndrome]]
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| *[[Epidural hematoma]]
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| *[[Exercise intolerance]]
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| *[[Ezetimibe ]]
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| *[[Facioscapulohumeral muscular dystrophy]]
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| *[[Fexofenadine and Pseudoephedrine ]]
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| *[[Fludrocortisone Acetate ]]
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| *[[Flunisolide Nasal Inhalation ]]
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| *[[Fluoride poisoning]]
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| *[[Fluticasone and Salmeterol Oral Inhalation ]]
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| *[[Fluvastatin ]]
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| *[[Frailty syndrome]]
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| *[[Friedreich's ataxia]]
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| *[[Galantamine ]]
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| *[[Gemeprost]]
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| *[[Glucocorticoids]]
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| *[[Glutaric aciduria type 1]]
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| *[[Glycogen storage disease type II]]
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| *[[GM1 gangliosidoses]]
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| *[[Graves' Disease]]
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| *[[Group A streptococcal infection]]
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| *[[Guanidinoacetate methyltransferase deficiency]]
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| *[[Guillain-Barre syndrome]]
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| *[[Hereditary inclusion body myopathy]]
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| *[[Hereditary spastic paraplegia]]
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| *[[Herpes zoster]]
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| *[[Hexane-2,5-dione]]
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| *[[HIV]]
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| *[[Hopkins syndrome]]
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| *[[Hydrochlorothiazide ]]
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| *[[Hydrocortisone Injection ]]
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| *[[Hydrocortisone Oral ]]
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| *[[Hydroxychloroquine ]]
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| *[[Hydroxyzine ]]
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| *[[Hyperaldosteronism]]
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| *[[Hypercalcemia]]
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| *[[Hyperkalaemic periodic paralysis]]
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| {{ColBreak}}
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| *[[Hyperkalemia]]
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| *[[Hypermagnesemia]]
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| *[[Hypermethioninemia]]
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| *[[Hyperpituitarism]]
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| *[[Hyperthyroidism]]
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| *[[Hypoglycemia]]
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| *[[Hypokalemic periodic paralysis]]
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| *[[Hypomagnesemia]]
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| *[[Hypophosphatemia]]
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| *[[Hypothyroidism]]
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| *[[Imiquimod ]]
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| *[[Inclusion body myositis]]
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| *[[Influenza]]
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| *[[Interferon Beta-1b Injection ]]
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| *[[Juvenile dermatomyositis]]
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| *[[Juvenile primary lateral sclerosis]]
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| *[[Kennedy disease]]
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| *[[Krabbe disease]]
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| *[[Lambert-Eaton myasthenic syndrome]]
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| *[[Leflunomide ]]
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| *[[Letrozole ]]
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| *[[Levalbuterol Oral Inhalation ]]
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| *[[Limb-girdle muscular dystrophy]]
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| *[[Lisinopril and Hydrochlorothiazide ]]
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| *[[Lithium ]]
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| *[[Loprazolam]]
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| *[[Lormetazepam]]
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| *[[Lovastatin ]]
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| *[[Low-carbohydrate diet]]
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| *[[Machado-Joseph disease]]
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| *[[Marinesco-Sjogren syndrome]]
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| *[[Mepyramine]]
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| *[[Metabolic acidosis]]
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| *[[Metachromatic leukodystrophy]]
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| *[[Methyclothiazide ]]
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| *[[Methyldopa and Hydrochlorothiazide ]]
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| *[[Methylprednisolone Oral ]]
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| *[[Metolazone ]]
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| *[[Mitochondrial trifunctional protein deficiency]]
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| *[[Motor neurone disease]]
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| *[[Multiple sclerosis]]
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| *[[Myasthenia gravis]]
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| *[[Nelson's syndrome]]
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| *[[Nemaline myopathy]]
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| *[[Nitrazepam]]
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| *[[Nitrofurantoin ]]
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| *[[Oxcarbazepine ]]
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| *[[Peripheral Arterial Disease]]
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| *[[Peripheral neuropathy]]
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| *[[Phosphofructokinase deficiency]]
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| *[[Poliomyelitis]]
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| *[[Polymyositis]]
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| *[[Postherpetic neuralgia]]
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| *[[Post-polio syndrome]]
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| *[[Pott's disease]]
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| *[[Pramipexole ]]
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| *[[Pravastatin ]]
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| *[[Prazosin and polythiazide ]]
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| *[[Prednisone]]
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| *[[Primary carnitine deficiency]]
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| *[[Primary hyperparathyroidism]]
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| *[[Primary lateral sclerosis]]
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| *[[Procyclidine ]]
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| *[[Pseudoephedrine and triprolidine ]]
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| *[[Pyridostigmine ]]
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| *[[Pyruvate carboxylase deficiency]]
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| *[[Reserpine, hydralazine, and hydrochlorothiazide ]]
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| *[[Rhabdomyolysis]]
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| *[[Rhabdomyolysis]]
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| *[[Rheumatoid Arthritis]]
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| *[[Rhinovirus]]
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| *[[Riluzole ]]
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| *[[Rosuvastatin ]]
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| *[[Salmeterol oral inhalation ]]
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| *[[Sandhoff disease]]
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| *[[Schilder's disease]]
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| *[[Scleroderma]]
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| *[[Selegiline ]]
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| *[[Sjogren's Syndrome]]
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| *[[Small fiber peripheral neuropathy]]
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| *[[Somatization disorder]]
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| *[[Spinal cord injury]]
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| *[[Spinal disc herniation]]
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| *[[Spinal stenosis]]
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| *[[Spironolactone ]]
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| *[[Spondylosis]]
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| *[[Sturge-Weber syndrome]]
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| *[[Tabes dorsalis]]
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| *[[Tamoxifen ]]
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| *[[Telbivudine ]]
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| *[[Temik]]
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| *[[Tension myositis syndrome]]
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| *[[Teriparatide (rDNA origin) Injection ]]
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| *[[Thyrotoxicosis]]
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| *[[Tocopherol]]
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| *[[Topiramate]]
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| *[[Trastuzumab ]]
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| *[[Triamcinolone Nasal Inhalation ]]
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| *[[Triamterene ]]
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| *[[Trimeprazine ]]
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| *[[Uremia]]
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| *[[Variegate porphyria]]
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| *[[Vitamin D deficiency]]
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| *[[Walker-Warburg syndrome]]
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| *[[Zoledronic Acid Injection ]]
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| {{EndMultiCol}}
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| ===Complete Differential Diagnosis of the Causes of Muscle weakness=== | | ==Treatment== |
| (By organ system)
| | [[Muscle weakness medical therapy|Medical Therapy]] | [[Muscle weakness primary prevention|Primary Prevention]] | [[Muscle weakness secondary prevention|Secondary Prevention]] | [[Muscle weakness cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Muscle weakness future or investigational therapies|Future or Investigational Therapies]] |
| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | | |
| [[Peripheral Arterial Disease]], | |
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| | ==Case Studies== |
| |-bgcolor="LightSteelBlue"
| |
| | '''Chemical / poisoning'''
| |
| |bgcolor="Beige"|
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| [[Cadmium poisoning]],
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| [[Dicamba]],
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| [[Fluoride poisoning]],
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| [[Hexane-2,5-dione]],
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| [[Temik]],
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|
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|
| |-
| | [[Muscle weakness case study one|Case #1]] |
| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
| |
| |bgcolor="Beige"|
| |
| [[3-Quinuclidinyl benzilate]], | |
| [[Acamprosate (patient information)]],
| |
| [[Acitretin (patient information)]],
| |
| [[Aluminum Hydroxide (patient information)]],
| |
| [[Amiloride and Hydrochlorothiazide (patient information)]],
| |
| [[Amiodarone Oral (patient information)]],
| |
| [[Beclomethasone Oral Inhalation (patient information)]],
| |
| [[Benztropine Mesylate Oral (patient information)]],
| |
| [[Bezafibrate (patient information)]],
| |
| [[Brompheniramine (patient information)]],
| |
| [[Budesonide Inhalation Powder (patient information)]],
| |
| [[Chloroquine Phosphate Oral (patient information)]],
| |
| [[Chlorothiazide (patient information)]],
| |
| [[Chlorpheniramine (patient information)]],
| |
| [[Chlorthalidone (patient information)]],
| |
| [[Ciclesonide Nasal Spray (patient information)]],
| |
| [[Clofibrate (patient information)]],
| |
| [[Colistimethate Injection (patient information)]],
| |
| [[Cyanocobalamin Injection (patient information)]],
| |
| [[Cyproheptadine (patient information)]],
| |
| [[Cytarabine (patient information)]],
| |
| [[Daptomycin]],
| |
| [[Desipramine (patient information)]],
| |
| [[Dexamethasone Oral (patient information)]],
| |
| [[Dextroamphetamine and Amphetamine (patient information)]],
| |
| [[Dicyclomine (patient information)]],
| |
| [[Diphenhydramine Oral (patient information)]],
| |
| [[Donepezil (patient information)]],
| |
| [[Dorzolamide and Timolol Ophthalmic (patient information)]],
| |
| [[Doxazosin (patient information)]],
| |
| [[Doxylamine (patient information)]],
| |
| [[Ezetimibe (patient information)]],
| |
| [[Fexofenadine and Pseudoephedrine (patient information)]],
| |
| [[Fludrocortisone Acetate (patient information)]],
| |
| [[Flunisolide Nasal Inhalation (patient information)]],
| |
| [[Fluticasone and Salmeterol Oral Inhalation (patient information)]],
| |
| [[Fluvastatin (patient information)]],
| |
| [[Galantamine (patient information)]],
| |
| [[Gemeprost]],
| |
| [[Glucocorticoids]],
| |
| [[Hydrochlorothiazide (patient information)]],
| |
| [[Hydrocortisone Injection (patient information)]],
| |
| [[Hydrocortisone Oral (patient information)]],
| |
| [[Hydroxychloroquine (patient information)]],
| |
| [[Hydroxyzine (patient information)]],
| |
| [[Imiquimod (patient information)]],
| |
| [[Insulin lispro injection (patient information)]],
| |
| [[Interferon Beta-1b Injection (patient information)]],
| |
| [[Leflunomide (patient information)]],
| |
| [[Letrozole (patient information)]],
| |
| [[Levalbuterol Oral Inhalation (patient information)]],
| |
| [[Lisinopril and Hydrochlorothiazide (patient information)]],
| |
| [[Lithium (patient information)]],
| |
| [[Loprazolam]],
| |
| [[Lormetazepam]],
| |
| [[Lovastatin (patient information)]],
| |
| [[Mepyramine]],
| |
| [[Methyclothiazide (patient information)]],
| |
| [[Methyldopa and Hydrochlorothiazide (patient information)]],
| |
| [[Methylprednisolone Oral (patient information)]],
| |
| [[Metolazone (patient information)]],
| |
| [[Nitrazepam]],
| |
| [[Nitrofurantoin (patient information)]],
| |
| [[Oxcarbazepine (patient information)]],
| |
| [[Pramipexole (patient information)]],
| |
| [[Pravastatin (patient information)]],
| |
| [[Prazosin and polythiazide (patient information)]],
| |
| [[Prednisone]],
| |
| [[Procyclidine (patient information)]],
| |
| [[Pseudoephedrine and triprolidine (patient information)]],
| |
| [[Pyridostigmine (patient information)]],
| |
| [[Reserpine, hydralazine, and hydrochlorothiazide (patient information)]],
| |
| [[Riluzole (patient information)]],
| |
| [[Rosuvastatin (patient information)]],
| |
| [[Salmeterol oral inhalation (patient information)]],
| |
| [[Selegiline (patient information)]],
| |
| [[Spironolactone (patient information)]],
| |
| [[Tamoxifen (patient information)]],
| |
| [[Telbivudine (patient information)]],
| |
| [[Teriparatide (rDNA origin) Injection (patient information)]],
| |
| [[Tocopherol]],
| |
| [[Topiramate]],
| |
| [[Trastuzumab (patient information)]],
| |
| [[Triamcinolone Nasal Inhalation (patient information)]],
| |
| [[Triamterene (patient information)]],
| |
| [[Trimeprazine (patient information)]],
| |
| [[Zoledronic Acid Injection (patient information)]],
| |
|
| |
|
| |-
| | ==Related Chapters== |
| |-bgcolor="LightSteelBlue"
| |
| | '''Ear Nose Throat'''
| |
| |bgcolor="Beige"|
| |
| [[Acute viral nasopharyngitis (common cold)]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Endocrine'''
| |
| |bgcolor="Beige"|
| |
| [[Addison's disease]],
| |
| [[Cushing's syndrome]],
| |
| [[Graves' Disease]],
| |
| [[Hyperaldosteronism]],
| |
| [[Hyperpituitarism]],
| |
| [[Hyperthyroidism]],
| |
| [[Hypothyroidism]],
| |
| [[Kennedy disease]],
| |
| [[Thyrotoxicosis]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Environmental'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Gastroenterologic'''
| |
| |bgcolor="Beige"| [[Cirrhosis]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Genetic'''
| |
| |bgcolor="Beige"|
| |
| [[Bassen-Kornzweig syndrome]],
| |
| [[Becker's muscular dystrophy]],
| |
| [[Carnitine palmitoyltransferase I deficiency]],
| |
| [[Dejerine Sottas syndrome]],
| |
| [[Devic's disease]],
| |
| [[Engelmann syndrome]],
| |
| [[Glutaric aciduria type 1]],
| |
| [[Glycogen storage disease type II]],
| |
| [[GM1 gangliosidoses]],
| |
| [[Hereditary inclusion body myopathy]],
| |
| [[Hereditary spastic paraplegia]],
| |
| [[Metachromatic leukodystrophy]],
| |
| [[Nemaline myopathy]],
| |
| [[Phosphofructokinase deficiency]],
| |
| [[Primary carnitine deficiency]],
| |
| [[Pyruvate carboxylase deficiency]],
| |
| [[Sandhoff disease]],
| |
| [[Walker-Warburg syndrome]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Hematologic'''
| |
| |bgcolor="Beige"|
| |
| [[Acute intermittent porphyria]],
| |
| [[Variegate porphyria]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Iatrogenic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Infectious Disease'''
| |
| |bgcolor="Beige"|
| |
| [[Botulism]],
| |
| [[Group A streptococcal infection]],
| |
| [[HIV]],
| |
| [[Influenza]],
| |
| [[Polymyositis]],
| |
| [[Pott's disease]],
| |
| [[Rhinovirus]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Musculoskeletal / Ortho'''
| |
| |bgcolor="Beige"|
| |
| [[Arthrogryposis]],
| |
| [[Congenital muscular dystrophy]],
| |
| [[Congenital myasthenic syndrome]],
| |
| [[Congenital myopathy]],
| |
| [[Dermatomyositis]],
| |
| [[Diabetic amyotrophy]],
| |
| [[Duchenne muscular dystrophy]],
| |
| [[Emery-Dreifuss Muscular Dystrophy]],
| |
| [[Facioscapulohumeral muscular dystrophy]],
| |
| [[Inclusion body myositis]],
| |
| [[Rhabdomyolysis]],
| |
| [[Spondylosis]],
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Neurologic'''
| |
| |bgcolor="Beige"|
| |
| [[Accessory nerve disorder]],
| |
| Acute peripheral neuropathy,
| |
| [[Amyotrophic lateral sclerosis]],
| |
| [[Arnold-Chiari malformation]],
| |
| [[Chronic inflammatory demyelinating polyneuropathy]],
| |
| [[Diabetic neuropathy]],
| |
| [[Epidural hematoma]],
| |
| [[Friedreich's ataxia]],
| |
| [[Guillain-Barre syndrome]],
| |
| [[Juvenile primary lateral sclerosis]],
| |
| [[Machado-Joseph disease]],
| |
| [[Marinesco-Sjogren syndrome]],
| |
| [[Motor neurone disease]],
| |
| [[Multiple sclerosis]],
| |
| [[Myasthenia gravis]],
| |
| [[Peripheral neuropathy]],
| |
| [[Sturge-Weber syndrome]],
| |
| [[Tabes dorsalis]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Nutritional / Metabolic'''
| |
| |bgcolor="Beige"|
| |
| [[3-Methylglutaconic aciduria]],
| |
| [[Guanidinoacetate methyltransferase deficiency]],
| |
| [[Metabolic acidosis]],
| |
| [[Vitamin D deficiency]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Obstetric/Gynecologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Oncologic'''
| |
| |bgcolor="Beige"|
| |
| [[Adrenal carcinoma]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Opthalmologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Overdose / Toxicity'''
| |
| |bgcolor="Beige"|
| |
| [[Benztropine Mesylate Oral (patient information)]],
| |
| [[Fexofenadine and Pseudoephedrine (patient information)]],
| |
| [[Galantamine (patient information)]],
| |
| [[Salmeterol oral inhalation (patient information)]],
| |
| [[Topiramate]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Psychiatric'''
| |
| |bgcolor="Beige"|
| |
| [[Anorexia nervosa]],
| |
| [[Bulimia nervosa]],
| |
| [[Tension myositis syndrome]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Pulmonary'''
| |
| |bgcolor="Beige"|
| |
| [[Hopkins syndrome]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Renal / Electrolyte'''
| |
| |bgcolor="Beige"|
| |
| [[Hypercalcemia]],
| |
| [[Hyperkalaemic periodic paralysis]],
| |
| [[Hypermagnesemia]],
| |
| [[Hypermethioninemia]],
| |
| [[Hypokalemic periodic paralysis]],
| |
| [[Hypomagnesemia]],
| |
| [[Hypophosphatemia]],
| |
| [[Uremia]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Rheum / Immune / Allergy'''
| |
| |bgcolor="Beige"|
| |
| [[Congenital myasthenic syndrome]],
| |
| [[Graves' Disease]],
| |
| [[Krabbe disease]],
| |
| [[Lambert-Eaton myasthenic syndrome]],
| |
| [[Rheumatoid Arthritis]],
| |
| [[Scleroderma]],
| |
| [[Sjogren's Syndrome]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Sexual'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Trauma'''
| |
| |bgcolor="Beige"|
| |
| [[Brachial plexus injury]],
| |
| | |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Urologic'''
| |
| |bgcolor="Beige"| No underlying causes
| |
| |-
| |
| |-bgcolor="LightSteelBlue"
| |
| | '''Miscellaneous'''
| |
| |bgcolor="Beige"|
| |
| [[Alcoholic polyneuropathy]],
| |
| [[Chronic fatigue syndrome]],
| |
| [[Mitochondrial trifunctional protein deficiency]],
| |
| [[Spinal cord injury]],
| |
| [[Spinal disc herniation]],
| |
| [[Spinal stenosis]],
| |
| |-
| |
| |}
| |
| | |
| == Differential Diagnosis ==
| |
| === Acute/Sub Acute ===
| |
| *[[Acute]] [[peripheral neuropathy]]
| |
| *[[Corticosteroids]]
| |
| *Coxsackie
| |
| *[[Dermatomyositis]]
| |
| *[[Herpes zoster]]
| |
| *[[HIV]]
| |
| *[[Hypercalcemia]]
| |
| *[[Hyperkalemia]]
| |
| *[[Hypermagnesemia]]
| |
| *[[Hypoglycemia]]
| |
| *[[Hypokalemia]]
| |
| *[[Hypophosphatemia]]
| |
| *[[Influenza]]
| |
| *[[Liver Disease]]
| |
| *[[Organophosphates]]
| |
| *[[Poliomyelitis]]
| |
| *[[Polymyositis]]
| |
| *[[Rabies]]
| |
| *[[Rhabdomyolysis]]
| |
| *[[Thyrotoxicosis]]
| |
| *[[Uremia]]
| |
| | |
| === Chronic Muscle Weakness ===
| |
| *[[Acromegaly]]
| |
| *Adrenocorticol insufficiency
| |
| *Alcoholic myopathy
| |
| *[[Amyotrophic lateral sclerosis ]]
| |
| *[[Charcot-Marie-Tooth Disease]]
| |
| *[[Chronic fatigue syndrome]]
| |
| *Chronic infection
| |
| *Chronic peripheral neuropathy
| |
| *[[Cushing's Syndrome]]
| |
| *[[Depression]]
| |
| *[[Dermatomyositis]]
| |
| *[[Diabetic neuropathy]]
| |
| *[[Drug]]s/[[toxins]]
| |
| *[[Duchenne's muscular dystrophy]]
| |
| *[[Eaton-Lambert syndrome]]
| |
| *Facioscapulohumeral
| |
| *[[Glycogen Storage Disease]]
| |
| *[[Hypercalcemia]]
| |
| *[[Hyperkalemia]]
| |
| *[[Hyperthyroidism]]
| |
| *[[Hyperparathyroidism]]
| |
| *[[Hypoglycemia]]
| |
| *[[Hypokalemia]]
| |
| *[[Hypophosphatemia]]
| |
| *[[Hypothyroidism]]
| |
| *Inflammatory myopathy
| |
| *[[Lipid storage disease]]
| |
| *[[Liver Disease]]
| |
| *[[Lupus erythematosus]]
| |
| *Malignant tumor
| |
| *[[Malnutrition]]
| |
| *Mitochondrial myopathy
| |
| *[[Mitral Regurgitation]]
| |
| *[[Mitral Stenosis]]
| |
| *[[Mixed Connective Tissue Disease]]
| |
| *[[Multiple Sclerosis]]
| |
| *[[Myasthenia gravis]]
| |
| *[[Myotonic ]]
| |
| *Oculopharyngeal
| |
| *Physical deconditioning
| |
| *[[Polymyositis]]
| |
| *[[Rhabdomyolysis]]
| |
| *[[Rheumatoid Arthritis]]
| |
| *[[Sjogren's Syndrome]]
| |
| *Somatization syndrome
| |
| *[[Steroid]] [[myopathy]]
| |
| *[[Uremia]]
| |
| *[[Vitamin D deficiency]]
| |
| ==Associated conditions==
| |
| Muscle weakness may be due to problems with the [[neuropathy|nerve supply]], [[neuromuscular disease]] such as [[myasthenia gravis]]) or problems with muscle itself. The latter category includes [[polymyositis]] and other [[myopathy|muscle disorders]]
| |
| | |
| * [[Amyotrophic lateral sclerosis]]
| |
| * [[Botulism]]
| |
| * [[Centronuclear myopathy (including myotubular myopathy)|Centronuclear myopathy]]
| |
| * Myotubular [[myopathy]]
| |
| * [[Dysautonomia]]
| |
| * [[Charcot-Marie-Tooth disease]]
| |
| * [[Hypokalemia]]
| |
| * [[Motor neurone disease]]
| |
| * [[Muscular dystrophy]]
| |
| * [[Myasthenia Gravis]]
| |
| * [[Progressive muscular atrophy]]
| |
| * [[Spinal muscular atrophy]]
| |
| * [[Cerebral palsy]]
| |
| * [[Infectious mononucleosis]]
| |
| * [[Herpes Zoster]]
| |
| * [[Vitamin D deficiency]]
| |
| * [[Fibromyalgia]]
| |
| * [[Celiac Disease]]
| |
| * [[Hypercortisolism]] ([[Cushing's syndrome]])
| |
| * [[Hypocortisolism]] ([[Addison's disease]])
| |
| * [[Primary hyperaldosteronism]] ([[Conn's syndrome]])
| |
| * [[Ehlers-Danlos syndrome]]
| |
| | |
| ==See also==
| |
| * [[Asthenia]] | | * [[Asthenia]] |
| * [[Paresis]] | | * [[Paresis]] |
| Line 684: |
Line 50: |
| * [[Dystrophy]] | | * [[Dystrophy]] |
|
| |
|
| ==Diagnostic Findings==
| | {{Symptoms and signs}} |
| | | {{WikiDoc Help Menu}} |
| [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
| | {{WikiDoc Sources}} |
| | |
| <div align="left">
| |
| <gallery heights="175" widths="175">
| |
| Image:Spinal cord ependymoma.jpg|Spinal cord ependymoma
| |
| </gallery>
| |
| </div>
| |
| | |
| ==References==
| |
| | |
| {{reflist|2}} | |
| | |
| {{Symptoms and signs}} | |
|
| |
|
| | [[Category:Disease]] |
| | [[Category:Emergency medicine]] |
| | [[Category:Endocrinology]] |
| | [[Category:Geriatrics]] |
| | [[Category:Genetic disorders]] |
| | [[Category:Immunology]] |
| | [[Category:Metabolic disorders]] |
| | [[Category:Neurology]] |
| | [[Category:Orthopedics]] |
| | [[Category:Rheumatology]] |
| [[Category:Symptoms]] | | [[Category:Symptoms]] |
| [[Category:Neurology]] | | [[Category:Signs and symptoms]] |
| | [[Category:Medical signs]] |
| [[Category:Muscular system]] | | [[Category:Muscular system]] |
| [[Category:Overview complete]]
| |
| [[Category:Signs and symptoms]]
| |
| [[Category:primary care]]
| |
|
| |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |
