Answer to question (EMQ) of the day – a history of weakness and fatigue

Uncategorized

Thanks for all of your great responses to our question of the day – some good analyses and discussion.

So here we go with the likely pathology …

  • Symmetrical findings make a central lesion less likely (they would localise).
  • The reflexes and sensation are intact, making a cord or peripheral nerve lesion unlikely.
  • The absence of fatigability makes a neuromuscular junction lesion less likely (myasthenia etc).
  • This sounds like a myopathy: the rash therefore suggests polymyositis (the rash is a heliotropic rash named after the purple heliotrope flower). The CK is likely to be very high (in the thousands, NR <150 iu/l).
  • The dysuria and cough are intended as distracters.

Look out for our next question of the day coming soon, and remember there are thousands more in the login area!

Posted in Uncategorized

Leave a Reply