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Emergency Medicine Clinics of North... Nov 2016Weakness is a common complaint in the emergency department, and a most challenging one, because before the emergency physician can proceed with an evaluation, the... (Review)
Review
Weakness is a common complaint in the emergency department, and a most challenging one, because before the emergency physician can proceed with an evaluation, the complaint of weakness must be fully clarified to determine about what the patient is actually complaining. This article will focus on causes of acute generalized nontraumatic bilateral weakness. Evaluation begins with the history and physical examination, followed by diagnostic testing in some cases.
Topics: Acute Disease; Diagnosis, Differential; Emergency Service, Hospital; Humans; Muscle Weakness; Physical Examination
PubMed: 27741989
DOI: 10.1016/j.emc.2016.06.006 -
Acute Medicine 2022A 48 year old lady presented with a 7-week history of progressive generalised myalgia and muscle weakness resulting in recurrent falls. Her past medical history included...
A 48 year old lady presented with a 7-week history of progressive generalised myalgia and muscle weakness resulting in recurrent falls. Her past medical history included bipolar affective disorder and a previous stroke. Her medications included clopidogrel 75mg, atorvastatin 80mg, and quetiapine 400mg twice daily.
Topics: Female; Humans; Middle Aged; Leg; Paresis; Muscle Weakness; Clopidogrel; Quetiapine Fumarate
PubMed: 36427216
DOI: 10.52964/AMJA.0917 -
Emergency Medicine Clinics of North... Feb 2021Weakness has a broad differential diagnosis. A paradigm for organizing possibilities is to consider what part of the nervous system is involved, ranging from brain,... (Review)
Review
Weakness has a broad differential diagnosis. A paradigm for organizing possibilities is to consider what part of the nervous system is involved, ranging from brain, spinal cord, nerve roots, and peripheral nerves to the neuromuscular junction. The clinician can consider internal versus external causes. Some neurologic conditions have subtle presentations yet carry a risk of short-term decompensation if not recognized. It is helpful to consider whether an emergency department presentation of weakness is a new disease process or represents an exacerbation of an established condition. Emergency presentations of weakness are challenging, and one must carefully consider potential serious causes.
Topics: Acute Disease; Diagnosis, Differential; Emergency Service, Hospital; Humans; Muscle Weakness
PubMed: 33218656
DOI: 10.1016/j.emc.2020.09.010 -
Muscle & Nerve Mar 2018
Topics: Animals; Botulinum Toxins; Botulinum Toxins, Type A; Muscle Weakness; Neuromuscular Agents; Paresis; Rats
PubMed: 29023937
DOI: 10.1002/mus.25988 -
American Journal of Respiratory and... Dec 2014Profound muscle weakness during and after critical illness is termed intensive care unit-acquired weakness (ICUAW).
RATIONALE
Profound muscle weakness during and after critical illness is termed intensive care unit-acquired weakness (ICUAW).
OBJECTIVES
To develop diagnostic recommendations for ICUAW.
METHODS
A multidisciplinary expert committee generated diagnostic questions. A systematic review was performed, and recommendations were developed using the Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
MEASUREMENT AND MAIN RESULTS
Severe sepsis, difficult ventilator liberation, and prolonged mechanical ventilation are associated with ICUAW. Physical rehabilitation improves outcomes in heterogeneous populations of ICU patients. Because it may not be feasible to provide universal physical rehabilitation, an alternative approach is to identify patients most likely to benefit. Patients with ICUAW may be such a group. Our review identified only one case series of patients with ICUAW who received physical therapy. When compared with a case series of patients with ICUAW who did not receive structured physical therapy, evidence suggested those who receive physical rehabilitation were more frequently discharged home rather than to a rehabilitative facility, although confidence intervals included no difference. Other interventions show promise, but fewer data proving patient benefit existed, thus precluding specific comment. Additionally, prior comorbidity was insufficiently defined to determine its influence on outcome, treatment response, or patient preferences for diagnostic efforts. We recommend controlled clinical trials in patients with ICUAW that compare physical rehabilitation with usual care and further research in understanding risk and patient preferences.
CONCLUSIONS
Research that identifies treatments that benefit patients with ICUAW is necessary to determine whether the benefits of diagnostic testing for ICUAW outweigh its burdens.
Topics: Adult; Critical Care; Electromyography; Humans; Intensive Care Units; Muscle Weakness; Neural Conduction; Physical Therapy Modalities
PubMed: 25496103
DOI: 10.1164/rccm.201411-2011ST -
The Journal of Family Practice Jul 2022► Muscle weakness ►Fatigue ► Electrolyte abnormalities.
► Muscle weakness ►Fatigue ► Electrolyte abnormalities.
Topics: Electrolytes; Fatigue; Humans; Male; Muscle Fatigue; Muscle Weakness
PubMed: 35994766
DOI: 10.12788/jfp.0455 -
Ugeskrift For Laeger May 2022A 42-year-old man of Chinese descent, known to have Graves' disease, presented with muscle weakness. Neurological examination showed paralysis of the arms and legs, with...
A 42-year-old man of Chinese descent, known to have Graves' disease, presented with muscle weakness. Neurological examination showed paralysis of the arms and legs, with intact sensory function, while blood-test revealed hypokalaemia and thyrotoxicosis. The neurological symptoms resolved quickly after correction of the serum potassium level. Thyrotoxic periodic paralysis is a rare, reversible complication of hyperthyroidism is characterised by hypokalaemia, hyperthyroidism and paralysis.
Topics: Adult; Graves Disease; Humans; Hyperthyroidism; Hypokalemia; Hypokalemic Periodic Paralysis; Leg; Muscle Weakness; Paralysis; Paresis
PubMed: 35506625
DOI: No ID Found -
Current Sports Medicine Reports Feb 2024
Topics: Humans; Volleyball; Universities; Athletes; Muscle Weakness
PubMed: 38315429
DOI: 10.1249/JSR.0000000000001136 -
World Neurosurgery Aug 2022Patients with malignant peripheral nerve sheath tumors (MPNSTs) of major motor nerves typically present with muscle weakness and pain. We aimed to analyze and...
OBJECTIVE
Patients with malignant peripheral nerve sheath tumors (MPNSTs) of major motor nerves typically present with muscle weakness and pain. We aimed to analyze and characterize patients with MPNSTs of major motor nerves but without muscle weakness at initial presentation.
METHODS
We performed a retrospective search of MPNSTs in a major nerve evaluated and/or treated at our institution from 1994 to 2019. Patients with no muscle weakness and available magnetic resonance imaging were analyzed. Clinical materials and magnetic resonance imaging and positron emission tomography scans were reviewed for features of malignancy. This group of patients was compared with patients who presented with MPNSTs and muscle weakness.
RESULTS
Of 26 patients with MPNSTs who presented with no muscle weakness, 21 (81%) had a positive family history for malignancy. Only 16 (62%) magnetic resonance imaging scans were highly suspicious for malignancy. All 7 available positron emission tomography scans were highly suspicious for malignancy. Patients who presented with muscle weakness (n = 36) were more likely to have paresthesias and a history of neurofibromatosis 1 or radiation to the MPNST location (P < 0.05).
CONCLUSIONS
MPNSTs of major motor nerves without muscle weakness represent an underappreciated subset of cases that have potential treatment and outcome implications. These patients presented with fewer symptoms and had fewer risk factors than patients with muscle weakness. Positron emission tomography should be considered as an additional method to try to anticipate the diagnosis of an MPNST.
Topics: Humans; Muscle Weakness; Nerve Sheath Neoplasms; Neurofibrosarcoma; Paresis; Positron-Emission Tomography; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 35513276
DOI: 10.1016/j.wneu.2022.04.104 -
Anesthesiology Jan 2016
Topics: Critical Care; Humans; Intensive Care Units; Muscle Weakness
PubMed: 26448468
DOI: 10.1097/ALN.0000000000000875