Hand weakness Assessment Questionnaire

Why: to establish if acute or chronic.

Why: may help determine cause of weakness e.g. movement at the wrist, knuckles or fingers.

Why: helps to determine which muscles and/or nerves are affected.

Why: helps to determine the cause of hand weakness e.g. muscle power decreases with use in myasthenia gravis.

Why: e.g. whiplash injury; Brachial plexus injury; fall onto outstretched hand - can determine possible cause of hand weakness.

Why: may suggest Guillain- Barre syndrome.

Why: diabetes, porphyria and Guillain-Barre syndrome are causes of predominantly motor peripheral neuropathy ; diabetes , hypertension and high cholesterol are risk factors for cerebrovascular disease (strokes).

Why: some medications can cause peripheral neuropathy e.g. amiodarone, phenytoin, nitrofurantoin; some medications may increase risk of thrombotic cerebrovascular disease e.g. oral contraceptive pill , hormone replacement therapy; some medications can increase the risk of hemorrhagic stroke e.g. warfarin.

Why: is a major risk factor for cerebrovascular disease.

Why: can be a cause of peripheral neuropathy.

Why: Stokes, Diabetes, High Cholesterol, Hypertension, Hereditary motor and sensory neuropathy.

Why: certain occupations requiring repetitive motions are at risk of causing work-induced overuse disorders with consequent muscle wasting and weakness e.g. process and meat workers are at risk of carpal tunnel syndrome due to rapid finger and wrist movement.

Why: e.g. lead poisoning is a cause of predominantly motor peripheral neuropathy; botulism food poisoning may cause weakness that progresses from head, neck, arms, hands, body and then legs.

Why: a painful joint, muscle or bone disease may interfere with assessment of hand power.

Why: if there is also paresthesia in the involved extremity this may suggest herniated cervical disc , spinal cord tumor or cervical spondylosis. Other conditions to consider are brachial plexus neuropathy, thoracic outlet syndrome, cervical rib, Pancoast's tumor, Raynaud's disease, sympathetic dystrophy or various entrapment syndromes such as carpal tunnel syndrome and ulnar nerve entrapment at the elbow.

Why: may indicate that the cause of hand weakness originates from disorders of the cervical spine.

Why: e.g. weakness of the muscles of the face would suggest a diagnosis of cerebrovascular disease, a mass in the brain or spinal cord.

Why: may suggest cerebrovascular disease or mass in brain.

Why: e.g. difficulty with speaking, difficulty with swallowing, visual field defects, cranial nerve palsies, weakness of the leg on the same side, spasticity of affected limbs.

Why: e.g. paresthesia or "pins and needles" affecting the pulps of the thumb, index , middle and half of the ring finger. These symptoms are usually noticed after, rather than during, rapid use of the hands. There may also be pain, which may radiate up as far as the shoulder, from the inside of the wrist. There may also be muscle wasting and weakness of the hands.

Why: e.g. weakness of distal limb muscles, distal numbness, if more severe may have respiratory and facial muscle weakness.

Why: e.g. symmetrical weakness and paralysis that usually descends from head, neck, arm, hands, body and then legs; nausea, vomiting, abdominal pain, dizziness, blurred vision, dry mouth, dry throat.