Muscle weakness Assessment Questionnaire

Why: to establish if acute or chronic.

Why: e.g. foot, lower leg, thigh, upper arm, lower arm, facial, back.

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

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

Why: may suggest a viral illness itself as the cause of muscle weakness (e.g. influenza) or Guillain- Barre syndrome (symptoms begin 7-10 days after the infective illness).

Why: can determine possible cause of muscle weakness.

Why: muscle overuse may cause muscle weakness.

Why: diabetes and chronic renal failure can cause peripheral neuropathy which may result in muscle weakness ; diabetes, hypertension and high cholesterol are risk factors for cerebrovascular disease (stroke) which may result in muscle weakness; pernicious anemia may cause subacute combined degeneration of the cord and muscle weakness.

Why: some medications can cause peripheral neuropathy e.g. amiodarone, phenytoin, nitrofurantoin; some medications may increase risk of thrombotic cerebrovascular disease (stroke) 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, Duchenne muscular dystrophy.

Why: a painful joint or muscle disease may interfere with assessment of leg or arm power.

Why: if there is also paresthesia in the involved extremity this usually suggests neuropathy (disease of the nerves) as a cause. Need to consider peripheral neuropathy, Guillain-Barre syndrome, Friedrich's ataxia, multiple sclerosis, transverse myelitis, a herniated disc, spinal cord tumor, peroneal atrophy and syringomyelia.

Why: may indicate that the cause of leg weakness originates from disorders of the lumbar spine.

Why: if associated with limb weakness 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 arm and leg on the same side, spasticity of affected limbs.

Why: e.g. frequency of urination, excessive thirst, weight loss, fatigue, increased infections. Diabetes may be complicated by a painful peripheral neuropathy with a glove and stocking pattern numbness or a neuropathy that features predominantly muscle weakness.

Why: e.g. symptoms begin 7-10 days after an infective illness. It results in muscle paralysis which typically ascends from the lower to the upper limbs. Sensory loss (numbness) is usually minimal. If more severe may have respiratory and facial muscle weakness.

Why: e.g. sudden severe leg pain, pallor of skin, paresthesia or numbness of lower leg, paralysis or weakness of leg.

Why: e.g. long history of backache; pain initially in the lumbar back area and then radiating distally into buttocks and legs; numbness may be present in groin, medial thigh, big toe or little toe; with continued nerve root compression may get muscle weakness.

Why: e.g. wasting and weakness of the thigh and upper arm muscles, enlargement of male breasts, frontal baldness, shrinkage of the testicles, deterioration in vision.

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. wasting and weakness of the muscles below the knee, slow progression over many years, variable loss of sensation in lower legs.

Why: e.g. usually starts with the gradual onset of pain and stiffness of the small joints of the hands and feet. Joint pain is worse on waking, nocturnal pain with disturbed sleep, pain is relieved with activity. Morning and rest stiffness can last for hours. May be associated with weakness, weight loss, malaise and fatigue. There is muscle wasting around the affected joints, particularly the hands.

Why: e.g. ataxic gait (clumsy slapping down of the feet), weakness of lower limbs, numbness of feet, reduced vision, dementia.

Why: symptoms are often vague but may include e.g. weight loss, loss of appetite, tiredness, weakness, fever, depression, lack of menstrual periods, impotence, nausea, vomiting, diarrhea, confusion, fainting, abdominal pain, constipation, muscle aches, wasting and weakness.

Why: e.g. easy muscle fatigability especially eyelids, neck, shoulders, lower legs and trunk, droopy eyelids, double vision, weak voice.

Why: e.g. weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, depression, psychosis, insomnia, frequent urination, excessive thirst, growth arrest in children.