Cases:
1. A 13-year-old male presents with a two-year history of progressive weaknesses in both upper and lower extremities. He finds it difficult to lift heavy objects off a shelf. When sitting on the floor he has to hold onto objects such as a chair to pull himself up. On examination, there is significant wasting of muscles in the shoulders, upper arms, and hips. There is significant weakness on muscle testing (i.e., the patient is unable to exert a normal force with muscle contraction). On tapping the knee tendon there is a contraction of the quadriceps muscle in the leg, and on tapping the biceps tendon there is a contraction of the biceps muscle in the arm. No fasciculations are noted. There is normal muscle tone detected by passive movement …show more content…
A 35-year-old male presents with the sudden onset of weakness in his right upper extremity following a fall in which he landed on his right shoulder. These symptoms began about one month prior to his visit. On examination there is weakness and atrophy (wasting) of the deltoid and biceps muscle. No atrophy is noted elsewhere. No fasciculations are noted. Muscle tone at the elbow with extension at the elbow (stretching the biceps muscle) is reduced although normal elsewhere. Tapping the biceps muscle tendon fails to produce contraction of the biceps muscle of the right arm. Tapping of muscle tendons elsewhere produces a normal …show more content…
A 57-year-old woman was brought to the emergency room because of the sudden onset of unusual behavior. The patient appeared to have normal strength but to have difficulty properly using objects such as using a knife, fork or spoon. She appeared to grasp the objects and manipulate and move objects in a coordinated fashion. It appeared that she just forgot how to use these objects. For example, she would hold the spoon upside-down while attempting to eat. On examination, the patient has normal strength and tone. No involuntary movements are noted. Her movements appear purposeful and normal, specifically there is no tremor or shaking and they are not slow. No fasciculations are noted. Tapping muscle tendons elicits a normal
1. A 13-year-old male presents with a two-year history of progressive weaknesses in both upper and lower extremities. He finds it difficult to lift heavy objects off a shelf. When sitting on the floor he has to hold onto objects such as a chair to pull himself up. On examination, there is significant wasting of muscles in the shoulders, upper arms, and hips. There is significant weakness on muscle testing (i.e., the patient is unable to exert a normal force with muscle contraction). On tapping the knee tendon there is a contraction of the quadriceps muscle in the leg, and on tapping the biceps tendon there is a contraction of the biceps muscle in the arm. No fasciculations are noted. There is normal muscle tone detected by passive movement …show more content…
A 35-year-old male presents with the sudden onset of weakness in his right upper extremity following a fall in which he landed on his right shoulder. These symptoms began about one month prior to his visit. On examination there is weakness and atrophy (wasting) of the deltoid and biceps muscle. No atrophy is noted elsewhere. No fasciculations are noted. Muscle tone at the elbow with extension at the elbow (stretching the biceps muscle) is reduced although normal elsewhere. Tapping the biceps muscle tendon fails to produce contraction of the biceps muscle of the right arm. Tapping of muscle tendons elsewhere produces a normal …show more content…
A 57-year-old woman was brought to the emergency room because of the sudden onset of unusual behavior. The patient appeared to have normal strength but to have difficulty properly using objects such as using a knife, fork or spoon. She appeared to grasp the objects and manipulate and move objects in a coordinated fashion. It appeared that she just forgot how to use these objects. For example, she would hold the spoon upside-down while attempting to eat. On examination, the patient has normal strength and tone. No involuntary movements are noted. Her movements appear purposeful and normal, specifically there is no tremor or shaking and they are not slow. No fasciculations are noted. Tapping muscle tendons elicits a normal