General considerations

Any acute illness may present with weakness as a major symptom, although weakness is typically considered a neurological dysfunction. Therefore it is important to exclude clinically significant systemic disorders as well as primary disorders of the nervous system. It is worth bearing in mind that symptoms are often atypical in the elderly and the seriously ill.

In extreme cases, intubation of the trachea and mechanical ventilation may be required pending further diagnostic tests. However, assuming that the patient is not moribund, attention should be paid to the various systems of the body. Respiratory disorders, particularly exacerbation of chronic lung disease, asthma, and pneumonia, may all cause weakness. These should be excluded on clinical examination and chest radiographs. Cardiac failure and cardiogenic shock may also render patients weak, and clinical signs may be deceptive. Septic shock or the systemic inflammatory response syndrome may be associated with global weakness. Advanced renal and hepatic failure may also lead to weakness. Metabolic disorders such as hypokalemia and hypocalcemia should be excluded, as should anemia. Endocrine disorders, including thyrotoxicosis, myxedema, Addison's disease, Cushing's syndrome, and disorders of the pituitary gland, may lead to muscle involvement. In all the above scenarios, treatment must be directed at the underlying cause of the weakness, as well as supporting the patient's general condition.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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