Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-26T13:31:17.908Z Has data issue: false hasContentIssue false

Chapter 7 - Weakness

from Section 2 - Common Neurologic Presentations: A Symptom-Based Approach

Published online by Cambridge University Press:  10 January 2024

By
George A. Small  and
Melody Milliron
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

Weakness is often a very complicated ED presenting complaint. A detailed history and physical examination, and diligent search for etiology, are required. First, the clinician must elucidate true weakness versus fatigue. Fatigue is best defined as a decrease in the ability to perform motor functions. Fatigue may be the complaint for a broad differential diagnosis, including acute coronary syndrome, anemia, chronic inflammatory diseases, dehydration, hypoglycemia or other electrolyte derangements, adrenal insufficiency, a variety of infections, pulmonary disorders, medication side effects, and depression. These disorders are characterized by a lack of true muscular weakness on examination. True muscular weakness is not painful, and pain should guide the examiner to other etiologies such as fibromyalgia or polymyalgia rheumatica.

Keywords

symmetrybulbaranterior hornGuillain–Barre syndromeWest Nile virusmyopathy
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 84 - 93
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrus, P Michael Guthrie, J. Acute peripheral neurologic lesions. In Tintinalli, JE, (ed.) Tintinalli’s Emergency Medicine, 7th ed. McGraw-Hill, 2011.Google Scholar
Asimos, AW. Evaluation of the adult with acute weakness in the emergency department. Available at: www.uptodate.com/home.index.html. 2015Google Scholar
Donaghy, M. Brain’s Diseases of the Nervous System, 10th ed. Oxford University Press, 2002.Google Scholar
Dyck, P, Thomas, P. K. (eds.). Peripheral Neuropathy, 3rd ed. W. B. Saunders, 1993.Google Scholar
Engel, AG, Franzini-Armstrong, C (eds.). Myology, 2nd ed. McGraw-Hill, 1994.Google Scholar
Fernández-Frackelton, M. Bacteria. In Marx, J (ed.) Rosen’s Emergency Medicine, 8th ed. W. B. Saunders, 2013.Google Scholar
Fuchs, S. Weakness. In Schafermeyer, R (ed.) Strange and Schafermeyer’s Pediatric Emergency Medicine, 4th ed. McGraw-Hill, 2014.Google Scholar
Handel, DA, Gaines, SA. Chronic neurological disorders. In Tintinalli, JE (ed.) Tintinalli’s Emergency Medicine, 7th ed. McGraw Hill, 2011.Google Scholar
Lewis, ED, Mayer, SA, Noble, JM (eds.). Merritt’s Neurology, 10th ed. Lippincott Williams and Wilkins Publishers, 2000.Google Scholar
Miller, ML Approach to the patient with muscle weakness. 2015. Available at: www.uptodate.com/home.index.html.Google Scholar
Sethi, RK, Thompson, LL. The Electromyographer’s Handbook, 2nd ed. Little Brown and Company, 1989.Google Scholar
Stone, KC. Neurologic emergencies. In Stone, KC (ed.) Current Diagnosis and Treatment Emergency Medicine, 7th ed. McGraw Hill, 2011.Google Scholar
Swanson, PD. Signs and Symptoms in Neurology. Lippincott, 1984.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×