Muscle weakness and Myalgia: Difference between revisions

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{|
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! colspan="12" style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="3" style="background:#DCDCDC;" align="center" + |Medication−induced
! style="background:#DCDCDC;" align="center" + |[[Corticosteroids]]<ref name="pmid24083177">{{cite journal |vauthors=Gupta A, Gupta Y |title=Glucocorticoid-induced myopathy: Pathophysiology, diagnosis, and treatment |journal=Indian J Endocrinol Metab |volume=17 |issue=5 |pages=913–6 |date=September 2013 |pmid=24083177 |pmc=3784879 |doi=10.4103/2230-8210.117215 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Central obesity]]
* Excessive [[sweating]]
* [[Insomnia]]
* Reduced [[libido]] 
* [[Amenorrhoea|Amenorrhea]]
* [[Infertility]] 
* Psychological disturbances
| style="background:#F5F5F5;" align="left" + |
*Positive h/o medications
| style="background:#F5F5F5;" align="left" + |
* Facial and sphincter [[Muscle|muscles]] are usually spared
| style="background:#F5F5F5;" align="left" + |
* Positive [[ACTH stimulation test]]
* 24-hour urine [[cortisol]]
* Low dose [[dexamethasone suppression test]]
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Statins]]<ref name="pmid22001973">{{cite journal |vauthors=Tomaszewski M, Stępień KM, Tomaszewska J, Czuczwar SJ |title=Statin-induced myopathies |journal=Pharmacol Rep |volume=63 |issue=4 |pages=859–66 |date=2011 |pmid=22001973 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |60+
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−/+([[Rhabdomyolysis]])
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
*Positive h/o medications
*H/o other medication use
| style="background:#F5F5F5;" align="left" + |
* [[Tenderness]]
* Muscle aches
| style="background:#F5F5F5;" align="left" + |
* '''↑↑''' Liver enzymes
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* [[Necrosis]]
* Degeneration, and regeneration of fibers
* Phagocytic infiltration
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Alcohol]]<ref name="pmid11784353">{{cite journal |vauthors=Preedy VR, Adachi J, Ueno Y, Ahmed S, Mantle D, Mullatti N, Rajendram R, Peters TJ |title=Alcoholic skeletal muscle myopathy: definitions, features, contribution of neuropathy, impact and diagnosis |journal=Eur. J. Neurol. |volume=8 |issue=6 |pages=677–87 |date=November 2001 |pmid=11784353 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | +/−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Swelling]]
* Tender
* [[Erythema]] and induration
| style="background:#F5F5F5;" align="left" + |
* [[Alcohol]] intoxication
| style="background:#F5F5F5;" align="left" + |
* Change in [[mental status]]
* [[Telangiectasias|Telangiectasia]]
* [[Peripheral neuropathy]]
| style="background:#F5F5F5;" align="left" + |
* Monspecific and are normal in many patients
| style="background:#F5F5F5;" align="left" + |
* Normal or '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="6" style="background:#DCDCDC;" align="center" + |Endocrine
! style="background:#DCDCDC;" align="center" + |[[Cushing's disease]]<ref name="pmid25221399">{{cite journal |vauthors=Sharma V, Borah P, Basumatary LJ, Das M, Goswami M, Kayal AK |title=Myopathies of endocrine disorders: A prospective clinical and biochemical study |journal=Ann Indian Acad Neurol |volume=17 |issue=3 |pages=298–302 |date=July 2014 |pmid=25221399 |pmc=4162016 |doi=10.4103/0972-2327.138505 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |25 −45
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Decreased libido]]
* [[Obesity]]/[[weight gain]]
* [[Plethora]]
* Round face
* Menstrual changes
* [[Hirsutism]]
* [[Hypertension]]
* [[Ecchymoses]]
* [[Lethargy]]
* [[Depression]]
* Dorsal fat pad
* Abnormal glucose tolerance
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* Facial and sphincter [[muscles]] are usually spared
* [[Overweight]]
* Straie
* [[Moon face]]
* [[Hypertension|HTN]]
* [[Hyperpigmentation]]
| style="background:#F5F5F5;" align="left" + |
* Positive [[ACTH stimulation test]]
* 24-hour urine [[cortisol]]
* Low dose [[Dexamethasone suppression test|dexamethasone <nowiki/>suppression test]]
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Atrophy of type 2 muscle fibers, especially type 2B
| style="background:#F5F5F5;" align="left" + |Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Adrenal insufficiency]]<ref name="pmid30656022">{{cite journal |vauthors=Ruff RL, Weissmann J |title=Endocrine myopathies |journal=Neurol Clin |volume=6 |issue=3 |pages=575–92 |date=August 1988 |pmid=3065602 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |30−50 years
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Signs of [[glucocorticoid]], [[mineralocorticoid]], and, [[androgen]] deficiency
| style="background:#F5F5F5;" align="left" + |
* Signs of [[postural hypotension]]
* History of [[tuberculosis]]
* History of [[malignancy]]
* History of other [[autoimmune disease]]
| style="background:#F5F5F5;" align="left" + |
* [[Hypotension]] 
* [[Hyperpigmentation]] 
* Auricular−cartilage calcification 
* [[Vitiligo]]
| style="background:#F5F5F5;" align="left" + |
* [[Electrolyte abnormalities]]
* [[Hypoglycemia]] 
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Hyperaldosteronism]] with myopathy<ref name="pmid5037033">{{cite journal |vauthors=Sambrook MA, Heron JR, Aber GM |title=Myopathy in association with primary hyperaldosteronism |journal=J. Neurol. Neurosurg. Psychiatry |volume=35 |issue=2 |pages=202–7 |date=April 1972 |pmid=5037033 |pmc=494037 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |50
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>


[[Rhabdomyolysis]]
| style="background:#F5F5F5;" align="left" + |
* [[Palpitations]]
* [[Hypertension]]
| style="background:#F5F5F5;" align="left" + |
* Episodes of [[Palpation|increased heart beats]]
| style="background:#F5F5F5;" align="left" + |
* [[Hyperpigmentation]]
| style="background:#F5F5F5;" align="left" + |
* [[Hypokalemia]]
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Hyperthyroidism]]<ref name="pmid28746208">{{cite journal |vauthors=Li Q, Liu Y, Zhang Q, Tian H, Li J, Li S |title=Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report |journal=Medicine (Baltimore) |volume=96 |issue=30 |pages=e7591 |date=July 2017 |pmid=28746208 |pmc=5627834 |doi=10.1097/MD.0000000000007591 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |40
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="left" + |
* Signs of [[hyperthyroidism]]
| style="background:#F5F5F5;" align="left" + |
* H/o of [[weight loss]]
| style="background:#F5F5F5;" align="left" + |
* [[Sweating]]
* [[Tremor]]
* Neck swelling
| style="background:#F5F5F5;" align="left" + |
* Decreased [[TSH]]
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Non specific
| style="background:#F5F5F5;" align="left" + |
* [[Myotonic]]
|-
! style="background:#DCDCDC;" align="center" + |[[Hypothyroidism]]<ref name="pmid6627693">{{cite journal |vauthors=Khaleeli AA, Griffith DG, Edwards RH |title=The clinical presentation of hypothyroid myopathy and its relationship to abnormalities in structure and function of skeletal muscle |journal=Clin. Endocrinol. (Oxf) |volume=19 |issue=3 |pages=365–76 |date=September 1983 |pmid=6627693 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |55
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | + [[Rhabdomyolysis MRI|Rhabdomyolysis]]
| style="background:#F5F5F5;" align="left" + |
*  Signs of [[hypothyroidism]]
| style="background:#F5F5F5;" align="left" + |
* H/o [[weight gain]]
| style="background:#F5F5F5;" align="left" + |
* [[Myxedema|Myxoedema]] 
* Muscle pseudohypertrophy
| style="background:#F5F5F5;" align="left" + |
* Increased [[TSH]]
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Nonspecific 
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |Diabetic infraction<ref name="pmid25932331">{{cite journal |vauthors=Horton WB, Taylor JS, Ragland TJ, Subauste AR |title=Diabetic muscle infarction: a systematic review |journal=BMJ Open Diabetes Res Care |volume=3 |issue=1 |pages=e000082 |date=2015 |pmid=25932331 |pmc=4410119 |doi=10.1136/bmjdrc-2015-000082 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |45 
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* [[Cramps]]
* Sudden onset of [[pain]]
* Anterior thigh [[muscles]] are most commonly involved
| style="background:#F5F5F5;" align="left" + |
* H/O long standing [[diabetes]]
| style="background:#F5F5F5;" align="left" + |
* [[Swelling]]
* [[Tenderness]]
| style="background:#F5F5F5;" align="left" + |
* Elevated [[ESR]]
* [[Leukocytosis]]
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* [[Necrosis]]
* [[Edema]]
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="5" style="background:#DCDCDC;" align="center" + |Inflammatory/ Rheumatologic
! style="background:#DCDCDC;" align="center" + |[[Dermatomyositis]]<ref name="pmid1658649">{{cite journal| author=Dalakas MC| title=Polymyositis, dermatomyositis and inclusion-body myositis. | journal=N Engl J Med | year= 1991 | volume= 325 | issue= 21 | pages= 1487-98 | pmid=1658649 | doi=10.1056/NEJM199111213252107 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1658649  }}</ref>
| style="background:#F5F5F5;" align="center" + |40s−50s<br>Can affect children
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* [[Rash]]
* [[Dyspnea]]
* [[Weight loss]]
* [[Cough]] 
| style="background:#F5F5F5;" align="left" + |
* [[Viral infections]]
* [[Cancer]]
| style="background:#F5F5F5;" align="left" + |
* Heliotrope rash on face and hands
* [[Telangiectasia]]
* [[Erythema]]
* Mechanic's hands
* [[Gottron's papules|Gottron's sign]] ( violaceous scaly eruption ) 
| style="background:#F5F5F5;" align="left" + |
* '''↑↑''' [[Erythrocyte sedimentation rate|ESR]]
* '''↑↑''' [[C-reactive protein|CRP]]
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Perimysial mononuclear infiltrate
| rowspan="2" style="background:#F5F5F5;" align="left" + |
* [[Myopathic]]
|-
! style="background:#DCDCDC;" align="center" + |[[Polymyositis]]<ref name="pmid16586492">{{cite journal| author=Dalakas MC| title=Polymyositis, dermatomyositis and inclusion-body myositis. | journal=N Engl J Med | year= 1991 | volume= 325 | issue= 21 | pages= 1487-98 | pmid=1658649 | doi=10.1056/NEJM199111213252107 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1658649  }}</ref>
| style="background:#F5F5F5;" align="center" + |> 18 years
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* Similar to [[dermatomyositis]] without [[mucous]] and [[skin]] involvement
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* '''↑↑''' [[Erythrocyte sedimentation rate|ESR]]
* '''↑↑''' [[C-reactive protein|CRP]]
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Endomysial mononuclear infiltrate
* Patchy necrosis
|-
! style="background:#DCDCDC;" align="center" + |Inclusion body [[myositis]]<ref name="pmid16586493">{{cite journal| author=Dalakas MC| title=Polymyositis, dermatomyositis and inclusion-body myositis. | journal=N Engl J Med | year= 1991 | volume= 325 | issue= 21 | pages= 1487-98 | pmid=1658649 | doi=10.1056/NEJM199111213252107 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1658649  }}</ref>
| style="background:#F5F5F5;" align="center" + |50s
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Dysphagia]]
* Asymmetric weakness
| style="background:#F5F5F5;" align="left" + |
* [[Retrovirus]] (most common)
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* Antibodies to cytoplasmic 5'−nucleotidase
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* [[Inflammatory cells]]
* Invading [[muscle cells]]
* Vacuolar degeneration
* Inclusions or plaques
| style="background:#F5F5F5;" align="left" + |
* [[Neurogenic]]
|-
! style="background:#DCDCDC;" align="center" + |[[Fibromyalgia]]<ref name="pmid27803417">{{cite journal |vauthors=Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H |title=Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism |journal=Intern. Med. |volume=55 |issue=21 |pages=3185–3190 |date=2016 |pmid=27803417 |pmc=5140872 |doi=10.2169/internalmedicine.55.5926 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |40−50s
| style="background:#F5F5F5;" align="center" + |Generalized
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* [[Anxiety]] or depression features
* [[Fatigue]]
* Sleep disturbance
* [[Numbness]]
* [[Muscle spasms]]
| style="background:#F5F5F5;" align="left" + |
* History of [[depression]]
| style="background:#F5F5F5;" align="left" + |
* [[Tenderness]] in the soft tissue anatomical location
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#DCDCDC;" align="center" + |[[Polymyalgia rheumatica|Polymyalgia Rheumatica]]<ref name="pmid8948307">{{cite journal| author=Myklebust G, Gran JT| title=A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis. | journal=Br J Rheumatol | year= 1996 | volume= 35 | issue= 11 | pages= 1161-8 | pmid=8948307 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8948307  }}</ref>
| style="background:#F5F5F5;" align="center" + |50s
| style="background:#F5F5F5;" align="center" + |Diffuse
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* [[Weight loss]]
| style="background:#F5F5F5;" align="left" + |
* History of joints stiffness, worse in the morning
| style="background:#F5F5F5;" align="left" + |
* Restricted shoulder motion
| style="background:#F5F5F5;" align="left" + |
* '''↑↑''' [[Erythrocyte sedimentation rate|ESR]]
* '''↑↑''' [[C-reactive protein|CRP]]
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="5" style="background:#DCDCDC;" align="center" + |Genetic
! style="background:#DCDCDC;" align="center" + |[[Becker's muscular dystrophy|Becker muscular dystrophy]]<ref name="pmid25037084">{{cite journal |vauthors=Flanigan KM |title=Duchenne and Becker muscular dystrophies |journal=Neurol Clin |volume=32 |issue=3 |pages=671–88, viii |date=August 2014 |pmid=25037084 |doi=10.1016/j.ncl.2014.05.002 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |<13yrs
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Milder form of [[Duchenne muscular dystrophy|Duchenne]]
| style="background:#F5F5F5;" align="left" + |
* [[Growth delay]]
* Age of onset of symptoms is much delayed than [[Duchenne muscular dystrophy|duchenne]]
| style="background:#F5F5F5;" align="left" + |
* Positive Grower sign
| style="background:#F5F5F5;" align="left" + |
* Decreased amount of [[dystrophin]].
| style="background:#F5F5F5;" align="left" + |
* ↑↑
| rowspan="2" style="background:#F5F5F5;" align="left" + |
** Muscle fibril degeneration, regeneration
** Isolated fiber hypertrophy
** Muscle replacement with fat and connective tissue
| rowspan="2" style="background:#F5F5F5;" align="left" + |
* [[Myopathic]]
|-
! style="background:#DCDCDC;" align="center" + |[[Duchenne muscular dystrophy]]<ref name="pmid250370842">{{cite journal |vauthors=Flanigan KM |title=Duchenne and Becker muscular dystrophies |journal=Neurol Clin |volume=32 |issue=3 |pages=671–88, viii |date=August 2014 |pmid=25037084 |doi=10.1016/j.ncl.2014.05.002 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |<13 yrs
| style="background:#F5F5F5;" align="center" + | Proximal
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* Calf psedohypertrophy
* [[Cardiomyopathy]]
* [[Kyphoscoliosis]]
* [[Cognitive impairment]]
| style="background:#F5F5F5;" align="left" + |
* Early onset
| style="background:#F5F5F5;" align="left" + |
* Positive Grower sign
| style="background:#F5F5F5;" align="left" + |
* Errors in the Xp21 gene.
* Absence of [[dystrophin]].
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
|-
! style="background:#DCDCDC;" align="center" + |[[Limb-girdle muscular dystrophy|Limb−girdle muscular]] dystrophies<ref name="pmid18769252">{{cite journal |vauthors=Guglieri M, Straub V, Bushby K, Lochmüller H |title=Limb-girdle muscular dystrophies |journal=Curr. Opin. Neurol. |volume=21 |issue=5 |pages=576–84 |date=October 2008 |pmid=18769252 |doi=10.1097/WCO.0b013e32830efdc2 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |<15 yrs
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Calf hypertrophy
* Scapular winging
* [[Cardiomyopathy]]
* [[Cardiac arrhythmia|Cardiac arrhythmias]]
* Respiratory muscle weakness
| style="background:#F5F5F5;" align="left" + |
* [[Autosomal dominant]]
* Deterioration of ability to run/walk
| style="background:#F5F5F5;" align="left" + |
*[[Muscle weakness]] is generally symmetric 
| style="background:#F5F5F5;" align="left" + |
* [[LMNA]] gene
* CAV3 gene
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* [[Myopathic]]
|-
| style="background:#DCDCDC;" align="center" + |[[Myotonic dystrophy]]<ref name="pmid22995693">{{cite journal |vauthors=Udd B, Krahe R |title=The myotonic dystrophies: molecular, clinical, and therapeutic challenges |journal=Lancet Neurol |volume=11 |issue=10 |pages=891–905 |date=October 2012 |pmid=22995693 |doi=10.1016/S1474-4422(12)70204-1 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |<18 years
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Myotonia]]
* [[Cataracts]]
* [[Diabetes mellitus]]
* Frontal balding
* Cardiac arrhythmias
* [[Cholecystitis]]
* [[Pregnancy]]
* Eyelid [[ptosis]]
| style="background:#F5F5F5;" align="left" + |
* Positive family history
| style="background:#F5F5F5;" align="left" + |
* Muscles often contract and are unable to relax
| style="background:#F5F5F5;" align="left" + |
* Mutations in the [[DMPK]] gene
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* [[Myopathic]]
|-
| style="background:#DCDCDC;" align="center" + |[[Glycogen storage disease]]<ref name="pmid11957192">{{cite journal |vauthors=Kannourakis G |title=Glycogen storage disease |journal=Semin. Hematol. |volume=39 |issue=2 |pages=103–6 |date=April 2002 |pmid=11957192 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Autosomal recessive|AR]]
* [[Fatigue|Faituge]]
* [[Hypoglycemia]]
| style="background:#F5F5F5;" align="left" + |
* [[Exercise intolerance]]
| style="background:#F5F5F5;" align="left" + |
* [[Hypotonia]]
* [[Hepatomegaly]]
| style="background:#F5F5F5;" align="left" + |
* [[Lactic acidosis]]
* Elevated liver enzymes
* [[Ketosis]]
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="5" style="background:#DCDCDC;" align="center" + |Infectious
! style="background:#DCDCDC;" align="center" + |[[Lyme disease]]<ref name="pmid2795056">{{cite journal |vauthors=Schoenen J, Sianard-Gainko J, Carpentier M, Reznik M |title=Myositis during Borrelia burgdorferi infection (Lyme disease) |journal=J. Neurol. Neurosurg. Psychiatry |volume=52 |issue=8 |pages=1002–5 |date=August 1989 |pmid=2795056 |pmc=1031843 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +/−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Erythema Migrans
* Flu−like symptoms
* [[Lyme arthritis]]
* [[Neurological]] manifestations
| style="background:#F5F5F5;" align="left" + |
* H/o tick bite
* Hiking trip
| style="background:#F5F5F5;" align="left" + |
* Target−like [[lesions]]
* HSM
| style="background:#F5F5F5;" align="left" + |
* Clinical diagnosis
* +Serology
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
|-
! style="background:#DCDCDC;" align="center" + |[[Influenza]]<ref name="pmid6687269">{{cite journal |vauthors=Bove KE, Hilton PK, Partin J, Farrell MK |title=Morphology of acute myopathy associated with influenza B infection |journal=Pediatr Pathol |volume=1 |issue=1 |pages=51–66 |date=1983 |pmid=6687269 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + | Proximal and Distal
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="left" + |
* [[Fever]]
* [[Malaise]]
* [[Rhinorrhea]]
* [[Muscle pain]] worse with movement
| style="background:#F5F5F5;" align="left" + |
*Cold weather
*H/o Ill contacts
| style="background:#F5F5F5;" align="left" + |
* Muscle weakness, tenderness, and swelling.
| style="background:#F5F5F5;" align="left" + |
* '''↑↑''' Liver enzymes
* Positive PCR
| style="background:#F5F5F5;" align="left" + |
* '''↑↑'''
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
|-
! style="background:#DCDCDC;" align="center" + |[[Polio]]<ref name="pmid15933355">{{cite journal |vauthors=Howard RS |title=Poliomyelitis and the postpolio syndrome |journal=BMJ |volume=330 |issue=7503 |pages=1314–8 |date=June 2005 |pmid=15933355 |pmc=558211 |doi=10.1136/bmj.330.7503.1314 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |<5 yrs
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Asymmetrical [[paralysis]]
* [[Muscle atrophy]]
* [[Tremors]]
* [[Skeletal]] deformities
| style="background:#F5F5F5;" align="left" + |
* History of skipped immunization.
| style="background:#F5F5F5;" align="left" + |
* Normal
* [[Meningeal signs]]
* Asymmetrical flaccid paralysis
* Pharyngeal paralysis
| style="background:#F5F5F5;" align="left" + |
* Isolation from [[pharyngeal]]<nowiki/>secretions, CSF
* Positive serology
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* Neurological pattern
|-
! style="background:#DCDCDC;" align="center" + |[[Syphilis]]<ref name="pmid17235095">{{cite journal |vauthors=French P |title=Syphilis |journal=BMJ |volume=334 |issue=7585 |pages=143–7 |date=January 2007 |pmid=17235095 |pmc=1779891 |doi=10.1136/bmj.39085.518148.BE |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Negative
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Chancre]]
* [[Lymphadenopathy]]
* Condylomata lata
* [[Neurosyphilis|Neuro syphilis]]
* Cardiovascular syphilis
| style="background:#F5F5F5;" align="left" + |
* History of risk factors (MSM, unprotected sex, multiple sex partners)
| style="background:#F5F5F5;" align="left" + |
* Non−tender [[chancre]] in primary syphilis.
* Followed by [[rash]]
* Generalized [[lymphadenopathy]] in secondary syphilis
| style="background:#F5F5F5;" align="left" + |
* Darkfield examinations
* VDRL
* RPR
* [[FTA-ABS|FTA−ABS]]
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
|-
! style="background:#DCDCDC;" align="center" + |[[Pyomyositis]]<ref name="pmid15380499">{{cite journal |vauthors=Crum NF |title=Bacterial pyomyositis in the United States |journal=Am. J. Med. |volume=117 |issue=6 |pages=420–8 |date=September 2004 |pmid=15380499 |doi=10.1016/j.amjmed.2004.03.031 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>Distal
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Fever]]
* [[Malaise]]
* [[Psoas abscess]]
| style="background:#F5F5F5;" align="left" + |
* [[Immunocompromised]]
| style="background:#F5F5F5;" align="left" + |
** Muscles are painful, swollen, tender, and indurated.
** Depending on the site of involvement, it may mimic appendicitis (psoas muscle), septic arthritis of the hip (iliacus muscle), or epidural abscess (piriformis muscle).
| style="background:#F5F5F5;" align="left" + |
* Leukocytosis
* Elevated ESR
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* N/A
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="4" style="background:#DCDCDC;" align="center" + |Neurologic
! style="background:#DCDCDC;" align="center" + |[[Amyotrophic lateral sclerosis|ALS]]<ref name="pmid26629397">{{cite journal |vauthors=Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A |title=A comprehensive review of amyotrophic lateral sclerosis |journal=Surg Neurol Int |volume=6 |issue= |pages=171 |date=2015 |pmid=26629397 |pmc=4653353 |doi=10.4103/2152-7806.169561 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |>35
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>Distal
* Distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Dysphagia]]
* [[Spasticity]]
* [[Hyperreflexia]]
* [[Babinski's sign|Babinski's]] +
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* Both [[Upper motor neurons|upper]] and [[lower motor neuron]] signs 
| style="background:#F5F5F5;" align="left" + |
* Clinical diagnosis
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Nonspecific findings of chronic denervation with reinnervation
| style="background:#F5F5F5;" align="left" + |
* Neuropathic
|-
! style="background:#DCDCDC;" align="center" + |[[Stroke]]<ref name="pmid20412000">{{cite journal |vauthors=Baldwin K, Orr S, Briand M, Piazza C, Veydt A, McCoy S |title=Acute ischemic stroke update |journal=Pharmacotherapy |volume=30 |issue=5 |pages=493–514 |date=May 2010 |pmid=20412000 |doi=10.1592/phco.30.5.493 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |>65
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Dysphagia]]
* Unilateral/Bilateral weakness
| style="background:#F5F5F5;" align="left" + |
* H/o [[Hypertension|HTN]], [[dyslipidaemia]] [[Diabetes mellitus|DM]]
| style="background:#F5F5F5;" align="left" + |
* Weakness of the involved arm
| style="background:#F5F5F5;" align="left" + |
*Head CT
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Neuropathic
|-
! style="background:#DCDCDC;" align="center" + |[[GBS]]<ref name="pmid23628447">{{cite journal |vauthors=van Doorn PA |title=Diagnosis, treatment and prognosis of Guillain-Barré syndrome (GBS) |journal=Presse Med |volume=42 |issue=6 Pt 2 |pages=e193–201 |date=June 2013 |pmid=23628447 |doi=10.1016/j.lpm.2013.02.328 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |18  −350
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Ascending paralysis]]
| style="background:#F5F5F5;" align="left" + |
* Precedes a [[Gastrointestinal diseases|gastrointestinal disease]]
| style="background:#F5F5F5;" align="left" + |
* Weakness of lower extremities followed by upper extremities
| style="background:#F5F5F5;" align="left" + |
* Cytologic albumin ratio
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* Neuropathic
|-
! style="background:#DCDCDC;" align="center" + |[[Multiple sclerosis|Multiple Sclerosis]]<ref name="pmid22605909">{{cite journal |vauthors=Goldenberg MM |title=Multiple sclerosis review |journal=P T |volume=37 |issue=3 |pages=175–84 |date=March 2012 |pmid=22605909 |pmc=3351877 |doi= |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |30's
| style="background:#F5F5F5;" align="center" + |Proximal<br>&<br>distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Ocular findings
* [[Urinary incontinence]]
* Problems with [[Speech and language pathology|speech]] or [[swallowing]]
| style="background:#F5F5F5;" align="left" + |
* Attacks or exacerbation
| style="background:#F5F5F5;" align="left" + |
** Localized weakness
** Focal sensory disturbances
** Hyper reactive reflexes
** Increased tone or stiffness
| style="background:#F5F5F5;" align="left" + |
* Head CT ologo−clonal bands
| style="background:#F5F5F5;" align="left" + |
* Normal
| style="background:#F5F5F5;" align="left" + |
* N/A
| style="background:#F5F5F5;" align="left" + |
* Neuropathic
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Organ system
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Disease
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Age of onset
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle weakness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fever
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myalgia
! style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Contractures'''
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Gait abnormality
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Neuropathy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Atrophy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stiffness
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Myoglobinuria
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features
! style="background:#4479BA; color: #FFFFFF;" align="center" + |History
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical
Examination
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Laboratory Findings
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Creatine Kinase
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Muscle Biopsy
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Electromyogram
|-
! rowspan="3" style="background:#DCDCDC;" align="center" + |Neuromuscular
! style="background:#DCDCDC;" align="center" + |[[Botulinum]]<ref name="pmid15257512">{{cite journal |vauthors=Cherington M |title=Botulism: update and review |journal=Semin Neurol |volume=24 |issue=2 |pages=155–63 |date=June 2004 |pmid=15257512 |doi=10.1055/s-2004-830901 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="left" + |
* [[Double vision]]
* [[Blurred vision]]
* Drooping eyelids
* [[Slurred speech]]
* [[Difficulty swallowing]]
| style="background:#F5F5F5;" align="left" + |
* H/O food exposure 
| rowspan="3" style="background:#F5F5F5;" align="left" + |
* [[Hyporeflexia]]
* Decreased strength
| style="background:#F5F5F5;" align="left" + |
* +Toxin
| rowspan="3" style="background:#F5F5F5;" align="left" + |
* Normal
| rowspan="3" style="background:#F5F5F5;" align="left" + |
* N/A
| rowspan="3" style="background:#F5F5F5;" align="left" + |
* Myopathic
|-
! style="background:#DCDCDC;" align="center" + |[[Lambert-Eaton syndrome|Lambert−Eaton syndrome]]<ref name="pmid22094130">{{cite journal |vauthors=Titulaer MJ, Lang B, Verschuuren JJ |title=Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies |journal=Lancet Neurol |volume=10 |issue=12 |pages=1098–107 |date=December 2011 |pmid=22094130 |doi=10.1016/S1474-4422(11)70245-9 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Distal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* Weakness of the bulbar muscles
* Ocular
* Limb weakness
| style="background:#F5F5F5;" align="left" + |
* Weaknessa is often relieved temporarily after exertion or physical exercise.
| style="background:#F5F5F5;" align="left" + |
* Antibodies against voltage−gated calcium channels 
|-
! style="background:#DCDCDC;" align="center" + |[[Myasthenia gravis]]<ref name="pmid23193443">{{cite journal |vauthors=Jayam Trouth A, Dabi A, Solieman N, Kurukumbi M, Kalyanam J |title=Myasthenia gravis: a review |journal=Autoimmune Dis |volume=2012 |issue= |pages=874680 |date=2012 |pmid=23193443 |pmc=3501798 |doi=10.1155/2012/874680 |url=}}</ref>
| style="background:#F5F5F5;" align="center" + |Variable
| style="background:#F5F5F5;" align="center" + |Proximal
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + | −
| style="background:#F5F5F5;" align="center" + | +
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="center" + |<nowiki>+</nowiki>
| style="background:#F5F5F5;" align="center" + |−
| style="background:#F5F5F5;" align="left" + |
* [[Ocular]]
* [[Bulbar]] 
* Limb weakness
* Isolated neck, limbs and respiratory weakness
| style="background:#F5F5F5;" align="left" + |
* Weakness often worsens with activity
| style="background:#F5F5F5;" align="left" + |
* Antibodies that block or destroy nicotinic [[acetylcholine receptors]] 
|}

Revision as of 19:10, 20 April 2018

Organ system Disease Symptoms History Physical

Examination

Diagnosis
Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Medication−induced Corticosteroids[1] Variable Proximal + +
  • Positive h/o medications
  • Facial and sphincter muscles are usually spared
  • Normal
  • Normal
  • Normal
Statins[2] 60+ Proximal + −/+(Rhabdomyolysis)
  • N/A
  • Positive h/o medications
  • H/o other medication use
  • ↑↑ Liver enzymes
  • ↑↑
  • Necrosis
  • Degeneration, and regeneration of fibers
  • Phagocytic infiltration
  • Normal
Alcohol[3] Variable Proximal + +/−
  • Monspecific and are normal in many patients
  • Normal or ↑↑
  • Normal
  • Normal
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Endocrine Cushing's disease[4] 25 −45 Proximal +
  • N/A
  • Normal
  • Atrophy of type 2 muscle fibers, especially type 2B
Normal
Adrenal insufficiency[5] 30−50 years Proximal + +
  • Normal
  • Normal
  • Normal
Hyperaldosteronism with myopathy[6] 50 Proximal
&
distal
+

Rhabdomyolysis

  • Normal
  • Normal
  • Normal
Hyperthyroidism[7] 40 Proximal + + +
  • ↑↑
  • Non specific
Hypothyroidism[8] 55 Proximal + + + + + Rhabdomyolysis
  • ↑↑
  • Nonspecific 
  • Normal
Diabetic infraction[9] 45  Proximal + + + +
  • Normal
  • Normal
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Inflammatory/ Rheumatologic Dermatomyositis[10] 40s−50s
Can affect children
Proximal + + +
  • ↑↑
  • Perimysial mononuclear infiltrate
Polymyositis[11] > 18 years Proximal + + +
  • N/A
  • N/A
  • ↑↑
  • Endomysial mononuclear infiltrate
  • Patchy necrosis
Inclusion body myositis[12] 50s Proximal
&
distal
  • N/A
  • Antibodies to cytoplasmic 5'−nucleotidase
  • ↑↑
Fibromyalgia[13] 40−50s Generalized +
  • Normal
  • Normal
  • Normal
  • Normal
Polymyalgia Rheumatica[14] 50s Diffuse + + +
  • History of joints stiffness, worse in the morning
  • Restricted shoulder motion
  • Normal
  • Normal
  • Normal
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Genetic Becker muscular dystrophy[15] <13yrs Proximal + + +
  • Positive Grower sign
  • ↑↑
    • Muscle fibril degeneration, regeneration
    • Isolated fiber hypertrophy
    • Muscle replacement with fat and connective tissue
Duchenne muscular dystrophy[16] <13 yrs Proximal + + +
  • Early onset
  • Positive Grower sign
  • ↑↑
Limb−girdle muscular dystrophies[17] <15 yrs Proximal + + + +
  • LMNA gene
  • CAV3 gene
  • ↑↑
  • N/A
Myotonic dystrophy[18] <18 years Proximal
&
distal
+ + +
  • Positive family history
  • Muscles often contract and are unable to relax
  • Mutations in the DMPK gene
  • N/A
  • N/A
Glycogen storage disease[19] Variable Proximal +
  • ↑↑
  • Normal
  • Normal
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Infectious Lyme disease[20] Variable Proximal + + +/− +
  • H/o tick bite
  • Hiking trip
  • Clinical diagnosis
  • +Serology
  • N/A
  • N/A
  • N/A
Influenza[21] Variable Proximal and Distal + + + +
  • Cold weather
  • H/o Ill contacts
  • Muscle weakness, tenderness, and swelling.
  • ↑↑ Liver enzymes
  • Positive PCR
  • ↑↑
  • N/A
  • N/A
Polio[22] <5 yrs Proximal + + +
  • History of skipped immunization.
  • Isolation from pharyngealsecretions, CSF
  • Positive serology
  • N/A
  • N/A
  • Neurological pattern
Syphilis[23] Variable Negative + +
  • History of risk factors (MSM, unprotected sex, multiple sex partners)
  • N/A
  • N/A
  • N/A
Pyomyositis[24] Variable Proximal
&
Distal
+ + +
    • Muscles are painful, swollen, tender, and indurated.
    • Depending on the site of involvement, it may mimic appendicitis (psoas muscle), septic arthritis of the hip (iliacus muscle), or epidural abscess (piriformis muscle).
  • Leukocytosis
  • Elevated ESR
  • N/A
  • N/A
  • N/A
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Neurologic ALS[25] >35 Proximal
&
Distal
  • Distal
+ + +
  • N/A
  • Clinical diagnosis
  • Normal
  • Nonspecific findings of chronic denervation with reinnervation
  • Neuropathic
Stroke[26] >65 Proximal
&
distal
+ + +
  • Weakness of the involved arm
  • Head CT
  • Normal
  • Normal
  • Neuropathic
GBS[27] 18 −350 Proximal + +
  • Weakness of lower extremities followed by upper extremities
  • Cytologic albumin ratio
  • Normal
  • Normal
  • Neuropathic
Multiple Sclerosis[28] 30's Proximal
&
distal
+ +
  • Attacks or exacerbation
    • Localized weakness
    • Focal sensory disturbances
    • Hyper reactive reflexes
    • Increased tone or stiffness
  • Head CT ologo−clonal bands
  • Normal
  • N/A
  • Neuropathic
Organ system Disease Age of onset Muscle weakness Fever Myalgia Contractures Gait abnormality Neuropathy Atrophy Stiffness Myoglobinuria Other features History Physical

Examination

Laboratory Findings Creatine Kinase Muscle Biopsy Electromyogram
Neuromuscular Botulinum[29] Variable Distal + +
  • H/O food exposure
  • +Toxin
  • Normal
  • N/A
  • Myopathic
Lambert−Eaton syndrome[30] Variable Distal + + +
  • Weakness of the bulbar muscles
  • Ocular
  • Limb weakness
  • Weaknessa is often relieved temporarily after exertion or physical exercise.
  • Antibodies against voltage−gated calcium channels 
Myasthenia gravis[31] Variable Proximal + + +
  • Ocular
  • Bulbar 
  • Limb weakness
  • Isolated neck, limbs and respiratory weakness
  • Weakness often worsens with activity
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