The symptoms include headaches, soreness in the chewing muscles, and clicking or stiffness of the joints.
This chapter will discuss the evaluation of the weak patient. It will build on the chapter on examination of the motor system (Chapter 10) and will defer to the chapter on neuromuscular disorders (Chapter 21) for detailed discussion of many of the conditions. The evaluation of the patient complaining of weakness must proceed in an orderly fashion. Summary. In summary, the evaluation of the weak patient needs to be systematic. History can help determine whether the patient is truly weak, and the pattern of weakness. It can also help determine whether hereditary disorders or other associated metabolic or endocrine conditions are high on the list of possibilities. Decreases in the amplitude and duration of spikes are associated with muscle diseases, which also show faster recruitment of other muscle fibers to compensate for weakness. Recruitment is reduced in nerve disorders. Of the endocrine diseases, thyroid disease is common, but thyroid-related myopathy is uncommon; parathyroid-related myopathy should be suspected in a patient with muscle weakness and chronic renal failure. Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. An EMG is often used to evaluate unexplained muscle weakness, twitching or paralysis, and to find the causes of numbness, tingling and pain. EMG testing can differentiate between true weakness and reduced use because of pain or lack of motivation. Disorders of the neuromuscular junction also lead to dysphagia. Myasthenia gravis (MG) characteristically presents with intermittent swallowing difficulties that worsen throughout the meal or throughout the day, and are often associated with oculomotor abnormalities, diplopia, and facial muscle weakness. Temporomandibular joint disorder (TMJ) is the name given to a group of symptoms that cause pain in the head, face, and jaw. The symptoms include headaches, soreness in the chewing muscles, and clicking or stiffness of the joints. They often have psychological as well as physical causes.
http://www.dartmouth.edu/~dons/part_2/chapter_12.html http://www.dartmouth.edu/~dons/part_2/chapter_12.html http://www.thehealthsuccesssite.com/muscle-disorders.html http://www.aafp.org/afp/2005/0401/p1327.pdf http://www.asha.org/public/speech/disorders/ChildhoodApraxia/ http://peripheralneuropathycenter.uchicago.edu/learnaboutpn/evaluation/electodiagnostic/emg.shtml http://www.nature.com/gimo/contents/pt1/full/gimo35.html http://www.thehealthsuccesssite.com/muscle-disorders.html
muscle disorders are often evaluated by