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Arm weakness Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Arm weakness. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you noticed weakness in your arm?

    Why: to establish if acute or chronic.

  2. What areas of the arm are affected by the weakness?

    Why: e.g. forearm, elbow, upper arm or shoulder.

  3. Are both arms affected by weakness and is it symmetrical?

    Why: helps determine which joints, muscles and /or nerves may be affected e.g. peripheral muscle weakness due to peripheral neuropathy is symmetrical compared with individual nerve or nerve root disease which should be suspected if weakness is asymmetrical or confined to one limb.

  4. Is the hand also affected by the weakness?

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

  5. Aggravating factors?

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

  6. History of trauma?

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

  7. Past medical history?

    Why: diabetes and chronic renal failure can be a cause of peripheral neuropathy ; diabetes , hypertension and high cholesterol are risk factors for cerebrovascular disease.

  8. Dietary history?

    Why: Vitamin B12 deficiency can be a cause of peripheral neuropathy.

  9. Medications?

    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.

  10. Cigarette smoking?

    Why: is a major risk factor for cerebrovascular disease.

  11. Alcohol history?

    Why: can be a cause of peripheral neuropathy.

  12. Family history?

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

  13. Occupational history?

    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.

  14. Have you got weakness in one or both arms?

    Why: This can give some important clues as to the cause of the weakness. Weakness occurring on both sides of the body in roughly the same distribution is more likely to be as a result of a systemic condition. However weakness which is much more localized and asymmetrical is more likely to be as a result of a non-systemic or regional condition.

  15. When did the weakness begin?

    Why: If it began some time ago then it is more likely to be related to a condition exhibiting chronic deterioration, however if it began only recently then it may be as a result of an acute condition which may or may not need to be identified and treated urgently.

  16. Have you experienced weakness in any other limbs or in any other areas?

    Why: Different conditions can result in different combinations of motor weakness in your arms, legs and trunk. If you have had difficulties walking then you may be suffering from such conditions as stroke/cerebrovascular accident, transient ischemic attack, Guillain Barre Syndrome or Acute Spinal Cord Compression.

  17. Have you ever been diagnosed with stroke/cerebrovascular accident, transient ischemic attack, myocardial infarction, angina/ischemic heart disease, or peripheral vascular disease?

    Why: These are all conditions which may predispose you to suffer a stroke/cerebrovascular accident or transient ischemic attack. These can result in arm weakness along with other neurological symptoms such as abnormal sensation. These conditions all indicate disease of your blood vessels, and this blood vessel disease may extent to involve the blood vessels supplying your spinal cord (anterior spinal artery syndrome). If this is the case, then it may result in a particular pattern of arm weakness and other peripheral neurological symptoms.

  18. Have you experienced any abnormal sensation (paraesthesia) in your arms, and if so where?

    Why: The combination of muscle weakness and abnormal sensation may indicate a neurological cause for your symptoms.

  19. Have you recently suffered any trauma or injuries?

    Why: Trauma can cause arm weakness in several ways. If you have experienced trauma to your head then you may have suffered an injury to your brain which has resulted in arm weakness. If this is the case then your arm weakness may have begun some time after the initial trauma. If you have suffered trauma to your neck or spine then this can also cause muscle weakness, and may actually result in the complete loss of ability to perform some movements. You may have suffered trauma to your arm directly, such as a laceration or bone fracture. These types of injuries can damage or cause dysfunction of the nerves which supply the muscles of your arm, and the particular pattern of movements which you cannot perform may give an indication of which nerve has been injured.

  20. Have you recently been having headaches, vomiting, abnormal sleepiness (somnolence), or seizures?

    Why: These can all be signs of a brain tumor, and even though this is a very rare cause of arm weakness it needs to be ruled out because it can be medically disastrous if not diagnosed. Headaches and vomiting which tend to occur in the morning (or after waking up) have been particularly associated with brain tumors.

  21. Have you recently experienced any difficulties with your vision (impaired visual acuity), or urinary symptoms (incontinence, frequency, retention)?

    Why: Disturbances of visual acuity and of passing urine (micturition) can indicate multiple sclerosis which can be a cause of arm weakness as well.

  22. Have you experienced any changes in your voice (hoarseness$), facial weakness or other abnormalities in your face, such as difficulty looking in any particular directions (cranial nerve palsy)?

    Why: If you have additionally experienced any weakness or other symptoms in your face as well as arm weakness, then this may raise their suspicions of certain neurological conditions. Depending on the exact pattern of symptoms that you have experienced, they may assist your health professional to locate exactly where the cause for your symptoms is and this may in turn reveal what that cause is. You may experience changes in your voice as some conditions such as Pancoast Syndrome can affect the nerves which control your voice and those which control the muscles in your arm. One particular pattern of facial symptoms is Horner's Syndrome where one of your pupils may seem smaller than the other (meiosis), one eye may appear "sunken" (enophthalmos), one eyelid may "droop" (ptosis) and you may notice less sweating than usual on one forehead (anhydrosis).

  23. Have you recently experienced any fevers or infections (ear infection, sinus infection/sinusitis, dental infection/dental abscess, mastoiditis)?

    Why: In combination with certain patterns of neurological symptoms, which may include arm weakness, a fever may cause your health professional to consider the possibility that you have an infection or abscess in your brain (cerebral abscess). Their suspicion may be increased if you have recently suffered any infections (such as those listed above) as they may appear to resolve clinically whilst they have actually spread to involve your brain tissue and result in the formation of an abscess.

  24. Can you tell me about your diet?

    Why: Sometimes arm weakness can be as a result of a deficiency of vitamin B12, which can cause subacute combined degeneration of the spinal cord.

  25. Have you ever been diagnosed with an anemia, particularly macrocytic anemia or pernicious anemia?

    Why: These two types of anemia can be the result of a deficiency of vitamin B12. This may also result in subacute combined degeneration of the spinal cord and resultant arm weakness.

  26. Have you ever been diagnosed with gastrointestinal malabsorption?

    Why: There are many conditions which can result in malabsorption syndromes, and these in turn can cause deficiencies of a wide variety of vitamins which we need in order for our bodies to function properly. One such deficiency is vitamin B12 deficiency which in some cases can result in anemia, or in others subacute combined degeneration of the spinal cord with arm weakness.

  27. Have you ever been diagnosed with spinal cord compression?

    Why: This can result in arm weakness by impairing the function of the spinal cord and the motor nerves supplying the arm.

  28. Have you experienced any difficulties with passing urine or moving your bowels?

    Why: Compression of your spinal cord acute spinal cord compression) can result in arm weakness as well as dysfunction of the muscular sphincters which control your bladder and bowel.

  29. Are your symptoms continuing to get worse, or are you having difficulties breathing (breathing difficulties/respiratory failure)?

    Why: In concert with arm or limb weakness, these can indicate a condition which requires urgent medical treatment. Examples of this are Guillain Barre Syndrome and Acute Spinal Cord Compression.

  30. Have you ever been diagnosed with any neurological or spinal cord conditions?

    Why: Some of these conditions can result in the new onset of arm weakness, even though they were diagnosed some time ago.

  31. Do you smoke cigarettes?

    Why: Cigarette smoking can cause lung cancer which may additionally cause dysfunction of the motor nerves supply your arm (Pancoast syndrome) and so cause arm weakness.

  32. Have you or anyone in your family ever been diagnosed with motor neuron disease?

    Why: This is a condition which causes the cells which control your motor functions (but not sensory) to degenerate. It can cause arm weakness and muscular wasting. Importantly, it can be an inheritable condition however this is only the case in roughly ten percent of cases.

  33. Have noticed any of the muscles in your arms have changed in size (muscle wasting)?

    Why: There are several conditions which can result in both arm weakness and wasting of your muscles, particularly those in your upper arm or upper leg (proximal myopathy).

  34. Have you recently used crutches, had excess pressure exerted on your armpit (axillary pressure), or laid in a single position for a prolonged amount of time?

    Why: Whilst these may all sound rather unrelated, these can all cause dysfunction of one particular nerve in the arm. This dysfunction may be felt as arm weakness or an area of paraesthesia. You may not recall laying in a single position without moving for very long, as you would have been asleep at the time. The most common cause for you to do this is Saturday night syndrome where you may drink excessive alcohol, become intoxicated and sedated from the alcohol, then fall asleep without much movement whilst asleep.

  35. Have you ever been diagnosed with carpal tunnel syndrome?

    Why: This is a syndrome which can cause weakness of some distal arm movements, as well as pain and paraesthesia.

  36. Have you ever cut your arm (parasuicide) or suffered any lacerations to it?

    Why: These can damage a nerve in your arm, and so result in weakness and some areas of altered sensation.

  37. Have you ever damaged your elbow, or suffered any arm fractures or arm dislocations?

    Why: These can result in damage to another nerve in your arm which may result in weakness of some movements and sensory deficits.

  38. Have you ever been diagnosed with mononeuritis multiplex or diabetes mellitus?

    Why: Mononeuritis Multiplex is a condition where there is dysfunction of 2 or more peripheral nerves, including those that control some motor functions. It can cause arm weakness. A common cause of it is diabetes mellitus.

  39. Have you ever been tested for diabetes mellitus?

    Why: Diabetes is a surprisingly common disease which can cause either widespread or focal dysfunction of both sensory and motor nerves. Such nerve dysfunction and arm weakness can be delayed or prevented in those suffering diabetes by early diagnosis and appropriate management. You may need testing for this condition may times in your life as it can begin at any time, and a "negative" test does not rule out the possibility that you may have it at some later time.

  40. Have you or anyone in your family been diagnosed with a muscular dystrophy such as Duchenne's muscular dystrophy, Becker's muscular dystrophy or limb girdle dystrophy or facioscapulohumeral dystrophy?

    Why: Muscular dystrophies are inheritable conditions which result in abnormal muscle function and such things as arm or leg weakness. There are several different types which may be diagnosed at different stages of life. For example Duchenne's Muscular Dystrophy becomes obvious and is diagnosed during childhood, usually before the age of 10yrs. Becker's Muscular Dystrophy tends to become obvious later in life during between 20-40yrs, and tends to be milder than other types. Limb Girdle Dystrophy is usually diagnosed during adolescence, affects only certain joints (pelvic girdle, shoulder), and can be severe. Facioscapulohumeral dystrophy may be diagnosed anywhere from late childhood to early middle age, affects similar joints to limb girdle dystrophy with the additional of the face, and tends not to be severe.

  41. Have you ever been diagnosed with Cushing's syndrome, thyroid disease (hyperthyroidism), hypokalemia, alcoholism, rickets/osteomalacia or any cancers?

    Why: These are all potentially systemic disorders which can result in dysfunction of you muscles (acquired myopathy), particularly those in your upper leg or arm (Proximal Myopathy).

  42. Do you notice that your arm weakness becomes worse with more movement (fatigability), or does it improve as you move it more?

    Why: This is an important distinction to make, as muscle weakness which gets worse with movement can indicate myasthenia gravis. Muscle weakness which you feel "goes away" (you feel stronger with more movement) can indicate Eaton Lambert syndrome. These are both conditions which are the result of an abnormal immune response to your muscles. Myasthenia gravis can be a primary disease, or secondary to thymic tumor/thymoma, systemic lupus erythematosus, rheumatoid arthritis or hyperthyroidism. Eaton Lambert Syndrome tends to occur as a secondary condition to cancer (paraneoplastic syndrome) or very rarely autoimmune disease, though autoimmune diseases are more likely to cause myasthenia gravis.

  43. Do you take any regular medications? Can you tell me what medications you have taken in the past?

    Why: There are many different medications which can cause your muscles to not work properly myopathy, and so result in arm weakness. Examples of this are lithium, quinine, chloroquine, labetolol, cholesterol-lowering medications (statins/HMG CoA Reductase Inhibitors), steroids, colchicine, vincristine, cyclosporin, zidovudine, and procainamide.

  44. Do you currently or have you in the past used any illicit drugs, or alcohol? If so, can you tell me about it?

    Why: There are many non-prescribed medications which people may take that can result in muscle dysfunction (myopathy) and arm weakness. Examples of this include cocaine, heroin/diamorphine, and alcohol. Alcohol is not an illicit drug, however it can still cause muscle dysfunction when consumed in large quantities over prolonged periods of time (alcoholism).

  45. Have you ever been diagnosed with polymyositis or dermatomyositis?

    Why: These are both conditions which can cause inflammation of your muscles, and in the latter may also result in a typical skin rash (heliotrope rash).

  46. Have you recently noticed any odd or purple-colored rashes on your skin (heliotrope rash), particularly around your eyes and on the back of your knuckles?

    Why: The presentation of this very typical rash along with muscle tenderness and arm weakness can indicate dermatomyositis.

  47. Arm pain?

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

  48. Arm paresthesia?

    Why: if there is also paresthesia in the involved extremity this usually suggests 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.

  49. Neck pain?

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

  50. Are there any other areas of the body which are weak?

    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.

  51. Headaches?

    Why: may suggest cerebrovascular disease or mass in brain.

  52. Symptoms of stroke?

    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.

Conditions listing medical symptoms: Arm weakness:

The following list of conditions have 'Arm weakness' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Arm weakness or choose View All.

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