Lipid myopathies. The emergency physician should be cautious when prescribing medications to myasthenics for problems not related to myasthenia gravis. Thompson PD, Rosow LK,
Sarcopenia. Arvat E, Barohn RJ, Diagnosis and classification of idiopathic inflammatory myopathies.
A stepwise approach to narrowing this differential diagnosis relies on the history and physical examination combined with knowledge of the potential etiologies. Shin SC,
Logigian EL. Lacomis D. Practical approach to the patient with acute neuromuscular weakness. Chawla J. 1990 Mar;10(1):89-102. doi: 10.1055/s-2008-1041258.J Emerg Med. Lundberg IE, Differentiating lower motor neuron syndromes. et al. Diagnosis and management of hypocalcaemia [published correction appears in Hujoel IA. Parsonage-Turner syndrome. Neuro-Pharmacology Drugs to Avoid in Myasthenia 32 Drugs to Avoid with Myasthenia Gravis Antibiotics Heart medications Anesthesia Brain/Nerve Others ampicillin Quinidine Procainamide Lithium Timolol eye drops Amoxicillin Quinine Succinylcholine Phenytoin Cortisones ... Diltiazem Yellow: Few case reports of … Liguori I, Clarithromycin is a macrolide antibiotic. Determining the cause of muscle weakness can be challenging. Lucchinetti CF, Marzetti E.
Giacanelli M, Frailty and sarcopenia are clinical syndromes occurring in older people that can present with generalized weakness. Identifying abnormal findings, such as Chvostek sign, Babinski reflex, hoarse voice, and muscle atrophy, will narrow the possible diagnoses. doi: 10.1016/s0196-0644(84)80522-3. Terracciano C, Muscle strength grading. True muscle weakness must first be differentiated from subjective fatigue or pain-related motor impairment with normal motor strength. Electromyography is indicated when certain diagnoses are being considered, such as amyotrophic lateral sclerosis, myasthenia gravis, neuropathy, and radiculopathy, and may also guide biopsy. Kumar Maurya P, 1979 Aug 23;301(8):409-13. doi: 10.1056/NEJM197908233010805.Semin Neurol. Tiryaki E,
Diagnostic work-up in steroid myopathy. Current classification and management of inflammatory myopathies. Joyce NC, Myasthenia gravis Autoimmune myasthenia gravis Childhood MG Drug-induced MG Neonatal MG Transient AChR inactivation Arthrogryposis Ocular Anti-MuSK antibody positive Anti-AChR-antibody-negative Thymoma Domestic animals Myasthenic syndrome (Lambert-Eaton) Snake venom toxins Sarcopenia and frailty: new challenges for clinical practice. Given its broad differential diagnosis, muscle weakness can be challenging to evaluate in primary care practice. The utility of electrodiagnostic tests for the assessment of medically unexplained weakness and sensory deficit. Distal myopathies. Kim HS, Callaghan BC, To see the full article, log in or purchase access.This requires a history and physical examination, which guide laboratory testing, imaging, electrodiagnostic testing, and muscle biopsy.Address correspondence to Jason Wilbur, MD, University of Iowa Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242 (email: Looker AC, Wang CY. Inflammatory muscle diseases. Abstract: Myasthenia gravis (MG) is an autoimmune antibody-mediated disorder which causes fluctuating weakness in ocular, bulbar and limb skeletal muscles. Molina PE.
Horgan F, Lana-Peixoto MA, Aran L, Erythematous papules on dorsum of both hands. Late-onset Pompe disease with nemaline bodies. Myasthenia gravis. Although its prevalence in the general population is not well described, muscle weakness occurs in 5% of U.S. adults 60 years and older. Amyloid neuropathies. Tangen CM,
Zhou SF, The challenges of muscle biopsy in a community based geriatric population. Magnetic resonance imaging is indicated if there is concern for acute neurologic conditions, such as stroke or cauda equina syndrome, and may also guide muscle biopsy. Massey JM. Juel VC, Laboratory testing, including electrolyte, thyroid-stimulating hormone, and creatine kinase measurements, may also be helpful. COVID-19 is an emerging, rapidly evolving situation. Kulshreshtha D, Asymmetric weakness is more common in neurologic conditions, whereas pain is more common in neuropathies or radiculopathies. Garibaldi M,
Amoxicillin is a penicillin antibiotic. Kissel JT. Sayer AA. The association between serum calcium levels and Chvostek sign: a population-based study. N Engl J Med. A predisposition to tachycardia. Neurologic manifestations of major electrolyte abnormalities. et al. Iyadurai SJ, Donoghue OA, Jin LW. In this case report, myasthenia gravis (MG) is proposed as a probable side effect of treatment with omalizumab. et al.
Tjärnlund A, The role of electrodiagnostic testing, imaging, and muscle biopsy in the investigation of muscle disease. Cheng HT, Park SB, Statin-associated side effects. Frailty in older persons.