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The clinical spectrum of isolated peripheral motor dysfunction
Author(s) -
Sanderson Alan B.,
Arnold W. David,
Elsheikh Bakri,
Kissel John T.
Publication year - 2015
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24326
Subject(s) - fasciculation , medicine , etiology , hyperreflexia , weakness , amyotrophic lateral sclerosis , multifocal motor neuropathy , differential diagnosis , bulbar palsy , atrophy , disease , pediatrics , pathology , anesthesia , surgery , electroencephalography , psychiatry , mismatch negativity
: Isolated peripheral motor dysfunction due to lower motor neuron or peripheral nerve disorders presents an interesting challenge to clinicians because of the diverse differential diagnosis with a broad range of prognoses. Methods : We retrospectively reviewed clinical data of adults who presented over 12 years with muscle weakness, atrophy, or fasciculations, but without hyperreflexia or sensory involvement. Results : In 119 patients, 52% had a motor neuron disease (MND), 13% had immune neuropathies, 11% had genetic neuronopathies, 10% had residual or post‐polio syndrome, 5% had benign fasciculation, 1% had an infectious etiology, and 8% were not given a final diagnosis. Only MND patients had cognitive dysfunction or frontal release signs. Bulbar and respiratory symptoms virtually excluded consideration of immune neuropathy. Conclusions : Only half of the patients were diagnosed with MND. A significant minority have treatable conditions. Cognitive involvement, frontal release signs, and bulbar or respiratory symptoms are strongly suggestive of MND. Muscle Nerve 51: 358–362, 2015