The pattern of skeletal muscle weakness may suggest which neuromuscular diseases to consider.
Patterns of muscle weakness:
(1) proximal muscles
(2) distal muscles
(3) facial muscles
(4) bulbar and palatal muscles
Neuromuscular Disorder |
Proximal |
Distal |
Facial |
Bulbar or Palatal |
---|---|---|---|---|
inflammatory myopathy |
x |
|
|
x |
muscular dystrophy |
x |
|
|
|
inclusion body myositis |
|
x |
|
|
myositis with anti-SRP |
|
x |
|
|
myotonic dystrophy |
|
x |
x |
|
distal dystrophies |
|
x |
|
|
peripheral neurologic disorder |
|
x |
|
|
fascioscapulohumeral dystrophy |
|
|
x |
|
myasthenia gravis |
|
|
ptosis |
|
mitochondrial myopathy |
|
|
x |
|
CNS disorder (stroke, etc) |
|
|
x |
x |
cranial nerve palsy |
|
|
x |
|
where:
• anti-SRP = antibody to signal recognition particle
Specialty: Surgery, orthopedic