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Weakness

Weakness is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Defined as a decrease in physical strength or energy
  • Often multifactorial
  • Distinguish neuromuscular disorder vs. non-neuromuscular disorder
  • Categories of neuromuscular disorders:
    • Upper motor neuron (UMN) lesions:
      • Deep tendon reflexes (DTR) increased
      • Plantar reflexes upgoing
      • Increased muscle tone
      • Muscle atrophy absent
    • Lower motor neuron (LMN) lesions:
      • DTRs decreased to absent
      • Plantar reflexes absent or normal
      • Decreased muscle tone
      • Muscle atrophy present
      • Fasciculations
    • Neuromuscular junction (NMJ) lesions:
      • DTRs normal
      • Plantar reflexes normal or absent
      • Decreased muscle tone
  • Categories of non-neuromuscular disorders:
    • Infectious
    • Endocrine
    • Metabolic
    • Cardiac
    • Rheumatologic
    • Toxic
    • Psychiatric

Etiology

  • Neuromuscular disorders:
    • UMN lesions:
      • Multiple sclerosis
      • Amyotrophic lateral sclerosis (mixed)
      • Transverse myelitis
      • Poliomyelitis
    • LMN lesions:
      • Guillain–Barré syndrome
      • Toxic neuropathies
      • Impingement syndromes
      • Diphtheria
      • Porphyria
      • Seafood toxins
    • NMJ lesions/others:
      • Myasthenia gravis
      • Lambert–Eaton syndrome
      • Botulism
      • Periodic paralysis
      • Tick paralysis
  • Non-neuromuscular disorders:
    • Dehydration
    • Anemia
    • Electrolyte imbalances
    • Malignancy
    • Cerebrovascular accident
    • Head or neck trauma
    • Myocardial ischemia
    • Infection/sepsis:
      • UTI
      • Pneumonia
      • Meningitis
      • Mononucleosis
      • HIV
      • Arborviruses
    • Endocrine abnormalities:
      • Hypothyroidism
      • Adrenal crisis
      • Periodic paralyses
    • Rheumatologic disorders:
      • Systemic lupus erythematosus
      • Polymyalgia rheumatica
    • Toxins:
      • Medications
      • Environmental
      • Carbon monoxide poisoning
      • Cocaine
      • Alcohol

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Citation

Rosen, Peter, et al., editors. "Weakness." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307494/all/Weakness.
Weakness. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307494/all/Weakness. Accessed April 24, 2019.
Weakness. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307494/all/Weakness
Weakness [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307494/all/Weakness.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Weakness ID - 307494 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307494/all/Weakness PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -