Template:Weakness DDX

Weakness

• Neuromuscular weakness involves derangement of CNS (UMN), PNS (LMN), the motor endplate, or the muscle:
  • UMN:
    • CVA (Main)
    • Intracerebral Hemorrhage (ICH)
    • Multiple Sclerosis (MS)
    • Amyotrophic Lateral Sclerosis (ALS) (UMN & LMN)
  • Spinal cord disease:
    • Infection (Epidural Abscess (Spinal))
    • Infarction/ischemia
    • Trauma (Spinal Cord Syndromes)
    • Inflammation (Transverse Myelitis)
    • Tumor
  • Peripheral nerve disease:
    • Guillain-Barre
    • Toxins (Ciguatera)
    • Tick Paralysis
    • DM neuropathy (non-emergent)
  • NMJ disease:
    • Myasthenia Gravis crisis
    • Botulism
    • Organophosphate Toxicity
    • Lambert-Eaton Myasthenic Syndrome
  • Muscle disease:
    • Rhabdomyolysis
    • Dermatomyositis
    • Polymyositis
    • Alcoholic myopathy

• Non-neuromuscular weakness can be infectious, cardiovascular, metabolic, toxicologic:
  • Can't miss dx:
    • Acute Coronary Syndrome (Main)
    • Arrhythmia/Syncope
    • severe infection/Sepsis (Main)
    • Hypoglycemia
    • Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
    • Respiratory failure
  • Emergent Dx:
    • Symptomatic Anemia
    • Severe dehydration
    • Hypothyroidism
    • Polypharmacy
    • Malignancy