Muscle Weakness Interview

Question 1

What are the cardinal features that are relevant to a muscle weakness interview?

Answer 1

Site
Quality - not always relevant
Severity
Time course
Context
Relieving factors
Aggravating factors
Associated features

Question 2

What do you want to know about the site?

Answer 2

Where is the weakness?
Which muscles are weak?
Is weakness generalised or localised?
If localised, is it symmetric or asymmetric?
If symmetric, is it proximal, distal, or in another specific pattern?

Question 3

What do you want to know about severity?

Answer 3

What function patient has in affected area
Can patient move affected area against gravity or paralysed?
What activities of daily living (ADLs) can’t the patient do?
Ability to exercise

Question 4

What do you want to know about time course?

Answer 4

When did it start?
Did it come on suddenly?
Does it fluctuate?
Is it worse after activity?

Question 5

What do you want to know about context?

Answer 5

Ask patient if there was anything in particular they noticed at the time weakness started

Question 6

What do you want to know about relieving factors?

Answer 6

Does anything make it better?

Does it improve with rest?

Question 7

What do you want to know about aggravating factors?

Answer 7

Is there anything that makes it worse?

Is there anything that triggers an episode?

Question 8

What are the associated features?

Answer 8

Pain
Associated with other neurological changes
- Sensory changes
Breathing