PMID: 9255135Aug 1, 1997Paper

Approach to generalized weakness and peripheral neuromuscular disease

Emergency Medicine Clinics of North America
F LoVecchio, S Jacobson

Abstract

A large number of intellectually engaging and potentially serious neuromuscular diseases have been presented. The emergency medicine physician must be able to recognize those entities that have the potential to clinically deterioration. The evaluation of weakness requires a comprehensive, broad-based differential that is driven by the history and physical. Diagnostic testing is determined by the clinical suspicion as is the urgency for further work-up. The following are the final diagnoses of the eight illustrative cases that were presented at the beginning of this article. Case 1. This unfortunate woman had a metabolic myopathy that was only diagnosed after enzymatic analysis of a muscle biopsy. Her genetic defect, carnitine palmitoyltransferase deficiency, is unusual as it does not present until late in adolescence or slightly later in life. It is a defect in lipid metabolism in which long-chain fatty acids are unable to gain entrance into the mitochondrion for oxidative degradation. The defect is apparent only after prolonged exercise or fasting. In this patient, rhabddomyolysis led to acute renal failure that resolved without requiring temporary dialysis. Case 2. This patient had an elevated CPK-MM. Her EMG showed myopathic...Continue Reading

References

Jan 13, 1977·Journal of Neurology·H AltenkirchJ Helmbrecht
Oct 1, 1977·Journal of the Neurological Sciences·J Pearn
Apr 23, 1992·The New England Journal of Medicine·A H Ropper
Jul 1, 1990·The American Journal of Emergency Medicine·A Jagoda, G Renner
Apr 19, 1990·The New England Journal of Medicine·M C DalakasJ L Griffin
Jul 4, 1990·JAMA : the Journal of the American Medical Association·L R PierceT P Gross
Oct 4, 1990·The New England Journal of Medicine·R GoldH Reichmann
Jun 1, 1988·Brain : a Journal of Neurology·J H O'NeillJ Newsom-Davis
May 1, 1988·Journal of Neurology, Neurosurgery, and Psychiatry·J B WinerC Osmond
Dec 15, 1988·Annals of Internal Medicine·D B KudrowG E Mathisen
Jan 1, 1987·Annals of the New York Academy of Sciences·D GrobT Namba
Sep 15, 1988·The New England Journal of Medicine·D RothJ J Bourgoignie
May 1, 1985·Annals of Internal Medicine·K L MacDonaldM L Cohen
May 1, 1970·Journal of the Neurological Sciences·J C Walsh, J G McLeod
Aug 25, 1983·The New England Journal of Medicine·H SchaumburgM J Brown
May 1, 1984·The American Journal of Medicine·C O TacketP A Blake
Oct 1, 1994·Annals of Emergency Medicine·P Shayne, A Hart

❮ Previous
Next ❯

Citations

Sep 1, 2006·Archives of Toxicology·Praveena BaireddyCarey N Pope
Apr 8, 2003·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·P ChamouniP Czernichow
Jun 18, 2002·Pediatric Emergency Care·Jane F KnappJonathan I Singer
Aug 25, 2000·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·S A McLaughlin, M S Buchsbaum
Feb 4, 2003·The American Journal of Emergency Medicine·Chia-Chao WuShih-Hua Lin
Oct 21, 2004·The Cochrane Database of Systematic Reviews·C M WhiteL Turner-Stokes
Apr 23, 2010·Endocrine Research·Fatih KiliçliIlkay Cakir

❮ Previous
Next ❯

Related Concepts

Related Feeds

Botulism

Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium clostridium botulinum. Discover the latest research on botulism here.

Botulism (ASM)

Botulism is a rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium clostridium botulinum. Discover the latest research on botulism here.