Hello! :)
In previous post, I left
you with a question
How do we identify the
site and cause of lesion?
Important points in
history and neurological examination that is suggestive of myopathy are:-
1. MUSCLE WEAKNESS
According to Taber's
medical dictionary, Lacking physical strength or vigor; infirm especially as
compared with what would be the normal or usual for that individual.
Most muscle diseases
produces symmetrical weakness of the large muscles of the girdles and trunk.
A) HIP GIRDLE (MOST
COMMONLY AFFECTED)
- Difficulty in getting
up from squatting position or from low chair,
-Inability to climb
stairs,
-Waddling gait.
B) UPPER GIRDLE WEAKNESS
- Difficulty in hanging
clothes on a cloth line
-Difficulty in taking
down item from high shelves.
C) TRUNK WEAKNESS
-Difficulty in turning
in bed and getting up from recumbent position.
D) NECK MUSCLE
WEAKNESS
-Inability to control
neck while in a vehicle as it rapidly accelerates and decelerates.
-neck pain and
stiffness.
E) CRANIAL MUSCULATURE
WEAKNESS
1. FACIAL WEAKNESS:-
-Inability to close eyes
fully.
-Difficulty in drinking
with a straw.
2. OCCULAR WEAKNESS:- (I
will explain this below in bit detail )
-ptosis
-extraoccular movement
weakness are seen.
F) DISTAL MUSCULATURE
WEAKNESS
-Difficulty in opening lids of jar
-turning keys in
keyholes
-tend to trip on uneven
ground with repeated falls.
2. GAIT
3. FATIGUE
According to Taber's
medical dictionary, the condition of an organ or tissue in which its response
to stimulation is reduced or lost as a result of over activity.
Abnormal fatigability
after exercise can result from certain metabolic and mitochondrial myopathies.
And as I have already
discussed the importance of duration and intensity of exercise that
provokes fatigue. It helps to distinguish metabolic myopathies.
4. MYALGIA
-Episodic= metabolic
myopathies
-Constant=inflammatory
muscle disorders
5. OCULOBULBAR WEAKNESS
6. SENSORY SYSTEM =
NORMAL
7. MYOGLOBINURIA
- Why? As caused by the
excessive release of myoglobin from muscles during periods of rapid muscles
destruction (rhabdomyolysis)
-Results in renal
failure in severe cases.
-Patient complains of
exercise induced myalgia then ask about "Cola colored" or "red colored”
urine during this episodes.
That's all for today.
I hope it helped.
In next post I will
continue with the relation of age and progression to diagnose myopathy.
-Upasana Y. :)
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