8/5 Morning Report w/ Teresa: Approaches to weakness

A middle aged man w/ epilepsy and DM presents with subacute weakness and recurrent falls found to have hypoglycemia, AKI, transaminitis, and c/f myoglobinuria.

*Takeaway:

Approach to weakness:

1) Distinguish Generalized fatigue versus Localized neuromusclar weakness

2) If Generalized fatigue –> metabolic, infectious workup

3) If localized weakness:

a. UMN signs –> CNS (cerebral cortex, brainstem, spinal cord)

b. LMN signs –> anterior horn cells and beyond, including peripheral nerve, NMJ, muscle

c.