Generalized weakness resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo M.D.

Synonyms and Keywords: dystrophy, myasthenia gravis, Guillian-barre syndrome, polymyositis, emg


Generalized weakness or lack of strength is a direct term for the inability to exert force with ones muscles to the degree that would be expected given the individual's general physical fitness. The weakness may be caused due to affection in the muscle, nerve, or neuromuscular plate. Causes of generalized weakness may be as varied as cardiovascular, chemical, dermatologic, drugs side effects, endocrine, environmental, gastroenterologic, genetic, hematologic, iatrogenic, infectious, musculoskeletal, neurologic, nutritional, oncologic, overdose, psychiatric, and renal. A test of strength is often used during a diagnosis of a muscular disorder before the etiology can be identified. Many times, the cause of weakness may be identified with the history and physical examination; emg may guide into the type of weakness, but other times biopsy or other laboratory test may be necessary.


Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes


Shown below is an algorithm summarizing the diagnosis of Generalized weakness according to the American Academy of Neurology guidelines:

Generalized weakness symptoms
True motor weakness?
Evaluate for causes of fatigue or muscle pain
Myasthenia Gravis
Lambert-Eaton syndrome
Periodic paralysis
Metabolic myopathy
•Inclusion body myopathy
Amyotrophic lateral sclerosis
Multifocal motor neuropathy
Congenital myopathy
Congenital dystrophy
•Kearns-sayre syndrome
•Oculopharyngeal dystrophy
Ocular dystrophy
•Fascioscapulohumeral dystrophy
Myotonic dystrophy
Upper extremities
•Emery-Dreiffus dystrophy
•Hereditary distal myopathy
Lower extremities
Duchenne's muscular dystrophy
Becker's muscular dystrophy
Spinal muscular atrophy
•Limb girdle dystrophy


Treat the underlying cause.




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