Limb Weakness

LOWER MOTOR NEURON LIMB WEAKNESS - BILATERAL (contd)

Note the muscle groups involved and area of sensory impairment

DISTAL muscle groups -

involved

PROXIMAL muscle groups involved

SPECIFIC muscle groups involved.

POLYNEUROPATHY

reflexes absent or diminished reflexes present

MYOPATHY

MYOPATHY

FACIOSCAPULOHUMERAL DYSTROPHY

NEUROMUSCULAR

, Fatigue with repetitive effort- JUNCTION

- VARIABLE INTENSITY ^ HYSTERIA

LIMB WEAKNESS

LESION SITE

Cerebral hemispheres,----

midbrain, pons, medulla

Spinal cord

Anterior horn cell (+ spinal-cord)

DIFFERENTIAL DIAGNOSIS

Vascular}

Infection J

Demyelination-----

Demyelination----"

Spondylosis I disc disease Tumour Infection Vascular

(progressive muscular atrophy) Spondylosis/disc disease ] Tumour

PRELIMINARY INVESTIGATIONS

CT scan/MRI MRI

Visual evoked potentials CSF oligoclonal bands

Straight X-ray CT myelography MRI

Electromyography (EMG) CT Scan/MRI

(myelography - cervical roots, radiculography - lumbar roots)

Plexus/peripheral nerves — - Peripheral neuropathy

Trauma

Tumour infiltration

- Myasthenia gravis 1 Myasthenic syndrome J

Dystrophy J

Nerve conduction studies EMG, Tensilon test

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