This document discusses the approach to diagnosing myopathy. Myopathy refers to disorders affecting skeletal muscle. The diagnosis involves a clinical evaluation considering symptoms, family history, temporal evolution, and distribution of weakness. Laboratory tests like creatine kinase levels and electrophysiology exams can help, as well as muscle biopsy. Making a diagnosis is challenging as myopathies can present similarly to other diseases, so careful neurological examination is important to identify the pattern of weakness.
This document discusses the approach to diagnosing myopathy. Myopathy refers to disorders affecting skeletal muscle. The diagnosis involves a clinical evaluation considering symptoms, family history, temporal evolution, and distribution of weakness. Laboratory tests like creatine kinase levels and electrophysiology exams can help, as well as muscle biopsy. Making a diagnosis is challenging as myopathies can present similarly to other diseases, so careful neurological examination is important to identify the pattern of weakness.
This document discusses the approach to diagnosing myopathy. Myopathy refers to disorders affecting skeletal muscle. The diagnosis involves a clinical evaluation considering symptoms, family history, temporal evolution, and distribution of weakness. Laboratory tests like creatine kinase levels and electrophysiology exams can help, as well as muscle biopsy. Making a diagnosis is challenging as myopathies can present similarly to other diseases, so careful neurological examination is important to identify the pattern of weakness.
Division of Peripheral Nerve, Dr. Sutomo Hospital-Airlangga University Surabaya Myopathy:
Are the disorders affecting the channel,
structure or metabolism of skeletal muscle Myopathy • Congenital Myopathy and Congenital Muscular Dystrophy • Muscular Dystrophy • Metabolic Myopathy • Muscle Channelopathy • Inflammatory Myopathy • Toxic Myopathy Myopathy : How to Approach Diagnosis? Clinical Evaluation • Which “negative” and/ or “positive” symptoms does the Px. Experience? • What is the temporal evolution? • Does the patient have a family history of myopathic disorder? • Are the presipitating factors that trigger episodic weakness or stiffness? • Are any associated systemic symptoms and signs present? • What is the distribution of weakness? Positive and Negative symptoms: Muscle Disease Associated With Myalgia: Myopathies Associated With Muscle Contractures: Myopahies Associated With Muscle Stiffness: Causes of Myoglobinuria: What is the the temporal Evolution? What is the the temporal Evolution? What is the the temporal Evolution? Does the Patient Have a Family History of Myopathic Disorder: Are the precipitating Factors that trigger Episodic Weakness of Stiffness? Are any associated Systemic Symptoms or Sign Present? Are any associated Systemic Symptoms or Sign Present? Myopathies associated with Respiratory Insufficiency: What is distribution of Weakness? What is distribution of Weakness? • Pattern 1: proximal Limb- Girdle Weakness • Pattern 2: Distal weakness. • Pattern 3: Proximal Arm/ Distal Leg (Scapuloperoneal) weakness • Pattern 4: Distal Arm/ proximal Leg Weakness • Pattern 5: Ptosis with/ without Ophthalmoparesis. • Pattern 6: prominent Neck extensor Weakness • Pattern 7: bulbar weakness • Pattern 8: episodic Pain, weakness, and Myoglobinuria • Pattern 9: episodic Weakness delayed or unrelated to exercise • Pattern 10: stiffness and decreased Ability to relax Pattern 2: Predominantly distal weakness. Pattern 2: Predominantly distal weakness. Pattern 3: Proximal Arm/ Distal Leg (Scapuloperoneal) weakness Pattern 5: Ptosis with/ without Ophthalmoparesis. Pattern 6: prominent Neck extensor Weakness Pattern 8: episodic Pain, weakness, and Myoglobinuria Pattern 9: episodic Weakness delayed or unrelated to exercise Pattern 10: stiffness and decreased Ability to relax Laboratory Approach: • Creatine kinase • Electrophysiologyc examination • Muscle Biopsy DD/ of CK elevation Summary: • The diagnosis of myopathy have a lot of limitation • The symptoms of myopathy are similar with the other disease • Careful consideration of the distribution of muscle weakness and good neurological examination can help us to get a best diagnosis.