How Is Muscle Weakness Treated
Specific treatment for hypotonia will be determined by your child’s physician based on:
- your child’s age, overall health, and medical history
- the extent of the condition
- the underlying cause of the condition
- your child’s tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference.
No specific therapy is required to treat benign congenital hypotonia, but children with this problem may periodically need treatment for common occurrences associated with hypotonia, such as recurrent joint dislocations.
Treatment programs to help increase muscle strength and sensory stimulation programs are developed once the cause of your child’s hypotonia is established. Such programs usually involve physical therapy through an early intervention or school-based program among other forms of therapy.
Blood Tests To Identify Medical Causes Of Neuropathy
by Dr. Onyema Nnanna
Best practice is to identify and treat the causes of each person’s neuropathy.
that Massachusetts General Hospital Hospital often recommends for patients with small-fiber polyneuropathy .
Complete Blood Count
Measures the number of different blood cells. Abnormal results can suggest particular diseases including vitamin B12 deficiency or blood cancers.
Comprehensive Metabolic Panel
High blood or urine glucose levels suggest diabetes or pre-diabetes. Diabetes is the most common cause of small-fiber, and other types of neuropathy, in developed countries. This diagnosis should always be considered in any patient diagnosed with peripheral neuropathy. Ideally blood glucose should be measured in the morning after an overnight fast. Early diabetes symptoms include excess thirst and urination, weight loss or weight gain. BUN and creatinine measure how well your kidneys are working. Poor kidney function can cause neuropathy or influence treatment.
Thyroid Function Test
Measures hormones secreted by the thyroid gland in the throat. Too high and too low levels of thyroid hormones are associated with peripheral neuropathy. Symptoms of hypothyroidism include cold intolerance, weight gain, constipation, dry skin and hair loss, depression, weakness, as well as neuropathies. Symptoms of hyperthyroidism include weight loss, anxiety, poor sleep, as well as neuropathy. Both conditions can be effectively treated.
Tests for Vitamin Levels
Tests for Metals and Minerals
Quick Answers For Clinicians
Various genetic and environmental factors are thought to increase risk for inflammatory myopathies. Implicated factors include ultraviolet light exposure, previous infections , and respiratory tract disease . Statin exposure is associated with necrotizing autoimmune myositis . Some genetic characteristics that seem to confer risk for inflammatory myopathies include the human leukocyte antigen 8.1 haplotype , TIF1 variants , FYCO1 variants , HLA DRB1*08:03 and DRB1*11:01 , and PTPN22 variants .
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Overview And Understanding Of Myopathies In Systemic Illnesses
Muscle diseases represent a wide variety of both acquired and hereditary disorder. The underlying disease can involve muscles at both structural and functional levels including metabolism as well as muscle ion channel. The primary care physician is most likely to be involved in the initial diagnosis of inflammatory myopathy and of myopathy that results from systemic disease or toxic exposure . Please see Table Table11 for classification of myopathies with systemic disorders.
Cpk Blood Test: What Does It Mean If You Have High Cpk Levels
A CPK blood test checks for levels of creatine phosphokinase in the blood. Creatine enzymes are released from muscles or tissues if they are injured, damaged, or die off. High CPK levels can mean that a tissue has been damaged due to a person suffering a heart attack, stroke, or head injury. Elevated CPK levels in a blood test could also show up if a person has hypothyroidism, takes statins for a long time, or has an autoimmune condition.
Doctors usually arrange for a CPK blood test in an emergency situation, for example after a suspected heart attack to identify the extent of muscle damage. However, CPK levels can also be higher than normal because of strenuous exercise and inflammation of the muscles. Specific CPK lab tests can also be used to identify if muscle or tissue damage is in the heart, brain, or skeletal muscles.
In this article, you will find out what it means if your lab test results show high CPK levels. Of course, your doctor will run more tests to diagnose the underlying reasons for creatine kinase that is at abnormal levels. You will also learn about ways to keep your heart, bones, and brain function healthy to prevent health issues that can cause CPK levels to rise above normal.
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Types Of Muscle Weakness
Complaints of muscle weakness will often present some difficulty to a doctor, because this can refer to several different types of muscular problems. They are generally categorized into three however, the definitions between them can be somewhat blurred:
True muscle weakness. This refers to an instance when you are unable to use a specific muscle at all.
Muscle tiredness. This describes when you can use your muscles, but it requires more effort than usual, and causes physical exhaustion quickly.
Muscle fatigability. This is when your muscle still functions but feels weak quickly and takes a long time to recover.
What Do The Results Mean
If your results show you have a higher than normal level of CK, it may mean you have an injury or disease of the muscles, heart, or brain. To get more information, your provider may order tests to check the levels of specific CK enzymes:
- If you have higher than normal CK-MM enzymes, it may mean you have a muscle injury or disease, such as muscular dystrophy or rhabdomyolis.
- If you have higher than normal CK-MB enzymes, it may mean you have an inflammation of the heart muscle or are having or recently had a heart attack.
- If you have higher than normal CK-BB enzymes, it may mean you have had a stroke or brain injury.
Other conditions that can cause higher than normal CK levels include:
Learn more about laboratory tests, reference ranges, and understanding results.
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Diagnosis And Treatment For Muscle Weakness
Your doctor will ask you questions about your medical history, medications you are taking, and any unusual symptoms you are experiencing.
Diagnostic tests that may be ordered to help determine a diagnosis include:
- Bloodwork to assess levels of enzymes, electrolytes, hormones, and inflammatory markers
- Genetic testing to assess for genetic risk
- Magnetic resonance imaging of your brain, spinal cord, and nerves to assess for damage
- Electromyography to assess the electrical activity of your muscles
- Nerve conduction tests to assess how signals travel from your nerves to your muscles
- Muscle biopsies to examine the quality of your muscle tissue
- Lumbar puncture, also called a spinal tap, to assess the quality of your cerebrospinal fluid within your spinal canal
Only a licensed healthcare provider can determine proper treatment depending on the cause of your muscle weakness. Treatment options include medication, dietary changes, physical and occupational therapy, and in certain cases, surgery.
How Do I Prepare For A Creatine Kinase Test
In most cases, you dont need to do anything special to prepare for a creatine kinase blood test.
If your healthcare provider has ordered a CK test to diagnose a potential muscle disorder, you should limit your exercise to normal activities before the test, since muscle strain from exercise can temporarily increase CK levels in your blood.
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Rationale For Ck Testing
- A CK is a starting point in the evaluation of a child with motor delay, even if cognitive delay is more of a concern, and helps focus further testing and referrals.
- CK testing is quick and inexpensive.
- CK results can help clinicians differentiate between various disorders that cause weakness.
- The CK can help distinguish between central and peripheral causes of motor delay.
- There are many peripheral neuromuscular conditions where the CK is always elevated from birth and other conditions where CK is mildly elevated or normal .
Elevated CK warrants prompt referral to neurology. Normal CK does not rule out neuromuscular disease. A mildly elevated CK should be followed up. However, please note that a normal CK does not rule out neuromuscular diseases such as spinal muscular atrophy in this instance genetic testing is required to rule out the disorder.
What Are The Classifications Of Myopathy
Myopathy is separated into three different types based on toxicity:
- Myalgia.Myalgia refers to generalized pain in your muscles. There may be a small increase in the creatine kinase enzyme, which is associated with muscle damage. If you have an increase in kinase, it can be identified in your bloodstream through a routine blood test.
- Myositis.Myositis presents itself with muscle pain, tenderness, or weakness and a higher level of creatine kinase in your bloodstream.
- Rhabdomyolysis.Rhabdomyolysis is an extreme, life-threatening type of myopathy. Its brought on by muscle breakdown and significant creatine kinase elevations, up to 10 times greater than normal values. In some cases, rhabdomyolysis can be fatal due to acute renal failure. But rhabdomyolysis is rare, occurring in fewer than
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What Might Be Causing My Pets Weakness
“Weakness can be caused by many different problems and can involve a variety of body systems.”
Weakness can be caused by many different problems and can involve a variety of body systems. Some common causes of weakness include:
Heart disease heart failure, poor circulation, irregular heart beat
Anemia thin or iron-poor blood due to many causes
Metabolic disease low blood sugar , low calcium , high potassium , low potassium
Hormonal disease hypoparathyroidism , hypothyroidism , hyperthyroidism , hypoadrenocorticism
Bone/Muscle disorders arthritis, joint problems
Nerve/Muscle disorders spinal cord disease such as collapsed disc, nerve damage, myasthenia gravis , seizures
Laboratory And Radiologic Evaluation
The sequence and timing of the ancillary investigations varies with the clinical scenario. In a patient whose muscle weakness is suggestive of neurologic disease, early neuroimaging or lumbar puncture is indicated. If infectious disease is suspected, appropriate titers or cultures should be obtained. When a specific class or type of myopathy is suspected, appropriate testing should be performed.
If the cause of muscle weakness is unclear, serum chemistries should be obtained, as well as a thyroid-stimulating hormone assay to evaluate for electrolyte and endocrine myopathies. If an endocrinopathy is suspected, more specific assays can be performed based on clinical suspicion .8,1315,28,29,32
Next, investigations looking for inflammatory, rheumatologic, or genetic myopathies can be performed sequentially or concurrently. Although nonspecific, the creatine kinase level usually is normal in the electrolyte and endocrine myopathies .8,16,28,29 However, the CK level may be highly elevated in the inflammatory myopathies and can be moderately to highly elevated in the muscular dystrophies.16,23,25 Other conditions that can be associated with elevated CK levels include sarcoidosis, infections, alcoholism, and adverse reactions to medications. Metabolic myopathies tend to be associated with only mild to moderate elevations in CK levels.7,16
What Should I Expect During My Creatine Kinase Blood Test
You can expect to experience the following during a blood test, or blood draw:
- Youll sit in a chair, and a healthcare provider will check your arms for an easily accessible vein. This is usually in the inner part of your arm on the other side of your elbow.
- Once theyve located a vein, theyll clean and disinfect the area.
- Theyll then insert a small needle into your vein to take a blood sample. This may feel like a small pinch.
- After they insert the needle, a small amount of blood will collect in a test tube.
- Once they have enough blood to test, theyll remove the needle and hold a cotton ball or gauze on the site to stop the bleeding.
- Theyll place a bandage over the site, and youll be finished.
The entire procedure usually takes less than five minutes.
Can Be Delayed By Fluctuating Symptoms
Myasthenia gravis can be difficult to diagnose because weakness is a common symptom of many disorders. Add to this the fact that symptoms may be vague, fluctuate or only affect certain muscles. And MG doesnt perform on demand the eyelid that droops at 7 p.m. may not show for a 9 a.m. doctor appointment. Identification may be complicated further when more than one autoimmune disorder is involved. Its not unusual for a diagnosis of MG to be delayed sometimes up to two years.
These steps may be taken to confirm a diagnosis of MG:
- Neurological exam: This may include testing your reflexes, muscle strength, muscle tone, senses of touch and sight, gait, posture, coordination, balance and mental skills. Impaired eye movement or muscle weakness may prompt a doctor to evaluate further.
- Ice Test: Cooling of muscles affected by MG may transiently improve weakness. This test is simple and easily performed on a droopy eyelid, often helping to confirm a diagnosis of MG.
- Edrophonium Test: A short-acting drug called edrophonium chloride is given intravenously. If weakness, especially in the eye muscles, briefly and temporarily improves, it indicates you may have MG. The drug does this by blocking an enzyme that breaks down acetylcholine, the chemical that transmits signals from nerve endings to muscles. A trial use of oral pyridostigmine bromide is an alternative approach.
This information was abstracted from these sources:
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What Is Metabolic Myopathy
Metabolism is the process through which our cells convert fuel sources for instance, sugar into usable energy.
Like all cells, muscle cells depend on metabolism to function correctly. Muscle cells convert sugar and fat into adenosine triphosphate, or ATP, through the work of enzymes. ATP enables muscles to contract and function normally.
Metabolic myopathies occur when genetic differences cause insufficient levels of a particular enzyme that is used in this process. When this happens, the affected muscles cannot convert fuel into energy and thus cannot function.
What Do The Results Of A Creatine Kinase Test Mean
Blood test reports, including creatine kinase test reports, usually provide the following information:
- The name of the blood test or what was measured in your blood.
- The number or measurement of your blood test result.
- The normal measurement range for that test.
- Information that indicates if your result is normal or abnormal, high or low or positive or negative.
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How Can I Tell If My Pet Is Feeling Weak
Pets that feel weak often have difficulty getting to their feet and move slowly or unsteadily. Other signs include shaky muscles, fainting, or collapse. You may find your pet does not want to exercise, seems dull, and does not respond when you call. Weakness may be constant or may be intermittent . Intermittent weakness is sometimes called episodic weakness because your pet may show only episodes of weakness and is fine otherwise.
What Is A Ck
Creatine phosphokinase is an enzyme found mainly in the skeletal muscle, but also in the heart and brain. Higher-than-expected serum CK indicates leakage of CK through the muscle membrane, and suggests muscle damage either from cardiac or skeletal muscle. In children, elevated CK almost always reflects skeletal muscle damage.
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Keep Your Heart Healthy
Because high CPK levels are often associated with heart disease and heart attacks, its important to keep your heart in good health. Here are some of the best ways that you can prevent cardiac-related health issues.
Regular exercise. Getting more exercise is one of the simple ways you can prevent a heart attack. The journal Circulation reports that getting enough regular exercise can help to reduce your risk of heart attack and increase survival rates in the case of a heart attack. Exercise can reduce levels of bad cholesterol, lower blood pressure, and lower insulin resistance.19
Consume more garlic. Garlic has many beneficial properties that can help to keep your heart healthy. The Journal of Nutrition reported in 2016 that garlic supplements can provide cardiovascular protection by lowering cholesterol and hypertension levels.20
Change your diet. One way to protect the health of your heart and keep CPK levels within normal range is to switch to a Mediterranean diet. The European Journal of Nutrition reported that a diet rich in fruit and vegetables, whole grains, and oily fish can help to boost the hearts health. It was found that people who followed the Mediterranean diet were at less risk of heart disease.21
Indications Of The Need For Urgent Referral To A Neurologist:
- Tongue fasciculations
- Loss of or missed motor milestones
- Dysphagia/ failure to thrive combined with paradoxical, diaphragmatic breathing with the appearance of a bell-shaped chest
- CK greater than 3x normal
- Anticipated surgery, due to anesthesia concerns in children with neuromuscular disorders
If a patient has an indication for urgent referral, you should consider direct contact with the neurologists office to share concerns, as this may expedite the appointment.
Note: Urine the color of cola/tea, especially with muscle pain: send child immediately to the ER for urgent emergency intervention
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What Tests Are Used To Diagnose Distal Muscular Dystrophy
In diagnosing any form of muscular dystrophy, a doctor usually begins by taking a patient and family history and performing a physical examination. Much can be learned from these, including the pattern of weakness. The history and physical go a long way toward making the diagnosis, even before any complicated diagnostic tests are done.
The doctor also wants to determine whether the patients weakness results from a problem in the muscles themselves or in the nerves that control them. Problems with muscle-controlling nerves, or motor nerves, originating in the spinal cord and reaching out to all the muscles, can cause weakness that looks like a muscle problem but really isnt.
Usually, the origin of the weakness can be pinpointed by a physical exam. Occasionally, special tests called nerve conduction studies and electromyography are done. In these tests, electricity and very fine pins are used to stimulate and assess the muscles or nerves individually to see where the problem lies. Electromyography is uncomfortable but not usually very painful.
To determine which disorder is causing CK elevation, a doctor may order a muscle biopsy, the surgical removal of a small sample of muscle from the patient. By examining this sample, doctors can tell a great deal about whats actually happening inside the muscles. Modern techniques can use the biopsy to distinguish muscular dystrophies from infections, inflammatory disorders and other problems.