NEUROPATHY-GENERALIZED WEAKNESS

SUMMARY

1. CIDP: often proximal weakness, reasonably symmetrical, absent reflexes, can have a mix of motor and sensory involvement, demyelinating pattern on NCS (including block), neuropathic picture on EMG.

2. Multifocal Motor Neuropathy (MMN): pure motor, reflexes sometimes preserved, even brisk “oligo-focal” (may be able to identify individual involved nerves), NCS shows conduction block at unusual sites (i.e. not at wrist, elbow, etc.), anti-GM1 antibodies present.

3. MND: pure motor, usually mix of UMN & LMN signs, bulbar & respiratory involvement.

4. MG: pure motor, fatigability, bulbar & respiratory, ptosis & diplopia involvement, repetitive stim (or single-fibre EMG in involved muscles).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].