Myopathy & Neuromuscular Junction  
    Disorders: Differential Diagnosis
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DISTRIBUTION OF WEAKNESS MUSCLE FEATURES TIME COURSE Vesalius
General
  Asymmetry
  Distal ≥ Proximal
    Hereditary
  Face & Periocular
    · With EOM Weakness
    · No EOM Weakness
  Limb-Girdle Syndromes
     Focal
  Bulbar
  Congenital
  EOM
  Hamstring
  Paraspinous
  Posterior Neck
  Proximal Arms
    Elbow flexor
  Ptosis
  Quadriceps
  Respiratory
  Scapular
Weakness in most myopathies is
symmetric and maximal proximally.
Cramps
Muscle Fiber Activity
Muscle Size
 · Large Muscles
 · Weakness > Wasting
 · Wasting > Weakness
 · Absent
Pain
Tendon Reflexes
 Acute
Episodic
Fatigue
 · Myasthenia
Onset of weakness
 · Congenital
 · Infantile
Hereditary
SYSTEMIC FEATURES LAB FEATURES GENERAL TOPICS
Amyloid
Cardiac
 · With Myopathy
 · No myopathy
CNS
Endocrine
Gastro-Intestinal
Infections
Joint Contractures
Myoglobinuria
Neuropathy
Paraneoplastic
Renal
Respiratory Failure
Skeletal
Skin
 Autoantibodies
Creatine Kinase (CK):
 · Very High
 · Unexpectedly High
 · Low
Dystrophinopathy
Glycogen Storage
Immune & Inflammatory
Inclusion bodies
Ion Channel Disorders
Lipid Disorders
Mitochondrial Disorders
Muscle biopsy useful
Myofibrillar
Myosin Disorders
Pathology
 Immunomodulating therapy
Muscle innervation
 · Upper extremity
 · Lower extremity
Neuromuscular Syndromes
Sports
Toxic
Typical Disease Patterns
Vitamins & Nutrition

See Neuromuscular Syndromes
Go to Differential Diagnosis of Neuropathies
Return to Neuromuscular Home Page
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Other revisions

12/22/2011