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Meningitis; encephalitis neuritis, myelitis

Acute bacterial meningitis; recurrent bacterial meningitis; abscess (bacterial, fungal, paracytic); intracranial thrombophlebitis; subdural empyema (bacterial, fungal, paracytic); extradural abscess (cranial and spinal epidural); myelitis (Lyme disease); neuritis (Lyme disease); syphilitic; dorsal root ganglion disease; cyst formation (echinococcus), myopathy (parasites) tick paralysis

Sporadic disease; familial disease, iatrogenic disease

HIV-related neuropathies; HlV-related myopathy; progressive HIV-related encephalopathy; HIV-associated neoplasms; opportunistic infections; cerebrovascular complications

Ischemic stroke; hemorrhagic stroke: subarachnoid hemorrhage; arteriovenous malformations; subdural hematomas; epidural hematomas; spinal cord strokes

Parasagittal meningioma; infiltrative CNS tumor

Intraparenchymal metastasis; meningeal and ventricular metastases; spinal metastases; peripheral nerve metastases; paraneoplastic encephalomyelopathies; paraneoplastic motor neuron diseases; paraneoplastic neuromuscular junction and muscle disorders; paraneoplastic peripheral neuropathies

Multiple sclerosis; neuromyelitis opica; isolated inflammatory demyelinating CNS syndromes; acute disseminated encephalomyelitis

Acute inflammatory demyelinating polyradiculoneuropathy; chronic inflammatory demyelinating polyradiculoneuropathy; monoclonal gammopathies of undetermined significance; neuropathy with multiple myeloma; neuropathy with osteosclerotic myeloma; motor neuropathy with multifocal conduction block

Inflammatory vasculopathies; rheumatoid arthritis; systemic lupus erythematosus; progressive systemic sclerosis; myasthenia gravis; dermatomyositis/polymyositis; eosinophilic myositis; inclusion body myositis; Sjogren's disease; Behcet's disease; Mollarets syndrome; sarcoid

Acute head injury; spinal cord injury; whiplash injuries; trauma-induced brachial and lumbosacral plexopathies; mountain sickness; decompression sickness; lightning and electrical injuries

Todd's paresis; epilepsies related to CNS lesions

Complicated (hemiplegic) migraine


Anesthetics; cholinesterase inhibitors; penicillins; aminoglycosides; sulfonamides; isoniazid; rifampin; ethambutol; amphotericin B; chloroquine; alkylating agents; methotrexate; vinca alkaloids; cisplatinum; thiamine; pyridoxine; penicillamine; clofibrate; lovastatin and pravastatin; coronary artery bypass graft; cardiac catheterization; percutaneous transluminal coronary angioplasty; radiation damage; vaccinations

HNP, Herniated nucleus pulposis; AIDS, acquired immune deficiency syndrome; CMV, cytomegalovirus; IC/MCA, internal carotid middle cerebral artery; AIDP, inflammatory demyelinating polyneuropathy

acute in patients with deficiencies of enzymes that break down and utilize glycogen. The prototypical disorder that can be diagnosed by this test is McArdle's disease, or alpha-phosphorylase deficiency. Normally, in the presence of ischemia, muscle can shift to anaerobic glycolysis to satisfy its energy needs. In alpha-phosphorylase deficiency, glycogen cannot be used, and the muscle becomes weak and then develops an electrically silent cramp identical to that seen in rigor mortis. More sophisticated tests of oxygen utilization and energy production by muscle can be done in a human performance laboratory. Magnetic resonance (MR) spectroscopy is becoming more widely available for analyzing the level and distribution of high-energy phosphate compounds.

Physical therapists trained in evaluating the strength of individual muscles can be very helpful in systematically and semiquantitatively assessing and documenting changes in muscle strength over time. Pulmonary function tests are used to assess the presence and degree of weakness in the respiratory muscles in patients with disorders of the neuromuscular junction or acute inflammatory demyelinating polyneuropathy (Guillain-Barre syndrome).


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