Muscle weakness (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Weakness is a reduction in the strength of one or more muscles.

Inability to carry out normal daily activities

Measurable weakness may result from a variety of conditions including metabolic, neurologic, primary muscular diseases, and toxic disorders.

• Addison’s disease
• Hyperparathyroidism
• Low sodium or potassium
• Thyrotoxicosis

• Amyotrophic lateral sclerosis
• Bell’s palsy
• Cerebral palsy
• Guillain-Barre syndrome
• Multiple sclerosis
• Pinched nerve (for example, caused by a slipped disk in the spine)
• Stroke

• Becker muscular dystrophy
• Dermatomyositis
• Muscular dystrophy (Duchenne)
• Myotonic dystrophy

• Botulism
• Organophosphate poisoning (insecticides, nerve gas)
• Paralytic shellfish poisoning

• Anemia
• Myasthenia gravis
• Poliomyelitis

Call your doctor if you have:

• Prolonged, unexplained weakness
• Sudden weakness, particularly when it is in one area and not accompanied by other complaints, such as fever
• Sudden weakness following a viral illness
• Weakness in one area of the body

The doctor will examine you and ask questions about your medical history and symptoms, such as:

• Time pattern
  • When did the weakness begin?
  • Did it begin with an illness or injury?
  • Did it occur suddenly or gradually?
  • Is the weakness worse in the morning or at night?
  • Is the weakness noticed only after strenuous activity or exercise?
  • Did it start following a typical viral illness, such as a cold?
  • Did it start after a vaccination?

• Quality
  • Is the weakness constant or does it come and go, sometimes affecting different parts of your body?
  • Does the weakness affect breathing?
  • Does it affect talking, chewing, or swallowing?
  • Does it affect walking, climbing stairs, sitting, getting up?
  • Does it affect use of the hands, arms, or shoulders?
  • Is there pain with the weakness?
  • Is there numbness or tingling with the weakness?

• Location
  • Is the weakness limited to a specific area?
  • Has the area of weakness increased or decreased?

• Aggravating factors
  • What makes the weakness worse?
    • Physical activity
    • Rest
    • Hunger
    • Fatigue
    • Pain
    • Stress

• Relieving factors
  • Does anything help relieve the weakness?
    • Rest
    • Eating
    • Pain relief

• Other symptoms
  • What other symptoms do you have?
    • Fever
    • Injury
    • Pain
    • Numbness or tingling
    • Vomiting
    • Diarrhea
    • Weight loss
    • Headaches
    • Changes in vision
    • Change in skin color or temperature of the area affected
    • Change in mental state, alertness, or responsiveness

• Additional important information
  • What medications do you take?
  • Do you have any allergies?

Physical examination may include special attention paid to examination of heart, lungs, and thyroid gland. If there is a local area of weakness, the examination will focus on the nerve and muscle functions.

Diagnostic tests that may be done include:

• Blood tests for autoimmune disorders
• Blood tests such as a CBC and electrolytes
• Lumbar puncture (CSF collection)
• MRI or CT scan of your head and spine
• Muscle biopsy
• Nerve conduction studies
• Thyroid function tests
• Urinalysis

Treatment varies with the cause of weakness.

Physiotherapy may be advised to strengthen the muscles.

Directions to Hospitals Treating Muscle weakness

Depending on the cause for weakness, following complications may be seen:

• Paraparesis
• Respiratory arrest

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