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LMN Signs (Hand Wasting (Neuropathy (Generalised (HMSN), Mononeuritis…
LMN Signs
Hand Wasting
Anterior horn: syringomyelia, MND, polio
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Ix
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Proximal Myopathy
Bloods
- DM: glucose, HbA1c
- Muscle damage: CK, ESR, AST, LDH
- Endocrine: TSH, Ca, 9am cortisol, IGF-1
- Abs: anti-Jo1
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Examination
LMN Signs
- Wasting
- Fasciculation
- Hypotonia
- Hyporeflexia
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Bilateral, Symmetrical and Distal
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Differential
- HMSN
- Paraneoplastic
- Lead poisoning
- Acute: GBS, Botulism
Bilateral, Symmetrical and Proximal
Proximal myopathy
Differential
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Inflammation
- Polymyositis
- Dermatomyositis
Endocrine
- Cushing’s Syndrome
- Acromegaly
- Thyrotoxicosis
- Osteomalacia
- Diabetic Amyotrophy
Drugs: alcohol, statins, steroids
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