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Chapter 7 - Weakness

from Section 2 - Common Neurologic Presentations: A Symptom-Based Approach

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Weakness is often a very complicated ED presenting complaint. A detailed history and physical examination, and diligent search for etiology, are required. First, the clinician must elucidate true weakness versus fatigue. Fatigue is best defined as a decrease in the ability to perform motor functions. Fatigue may be the complaint for a broad differential diagnosis, including acute coronary syndrome, anemia, chronic inflammatory diseases, dehydration, hypoglycemia or other electrolyte derangements, adrenal insufficiency, a variety of infections, pulmonary disorders, medication side effects, and depression. These disorders are characterized by a lack of true muscular weakness on examination. True muscular weakness is not painful, and pain should guide the examiner to other etiologies such as fibromyalgia or polymyalgia rheumatica.

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Publisher: Cambridge University Press
Print publication year: 2023

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