Muscle function loss

Alternative Names: Paralysis; Paresis; Loss of movement; Motor dysfunction

Muscle function loss is when a muscle doesn't work or move normally. The medical term for complete loss of muscle function is paralysis.

Considerations

Loss of muscle function may be caused by:

• A disease of the muscle itself (myopathy)
• A disease of the nervous system: nerve damage (neuropathy), or spinal cord injury, or brain damage (stroke or other brain injury)

The loss of muscle function after these types of events can be severe, and often will not completely return.

Paralysis can be temporary or permanent. It can affect a small area (localized) or be widespread (generalized). It may affect one side (unilateral) or both sides (bilateral).

If the paralysis affects the lower half of the body and both legs it is called paraplegia. It if affects both arms and legs, it is called quadriplegia. If the paralysis affects the muscles that cause breathing, it is quickly life threatening.

Causes of Muscle function loss

Diseases of the muscle that cause muscle-function loss include:

• Alcohol-associated myopathy
• Dermatomyositis and polymyositis
• Muscular dystrophy

Diseases of the nervous system that cause muscle function loss include:

• Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease)
• Bell's palsy
• Botulism
• Guillain-Barre syndrome
• Neuropathy
• Paralytic shellfish poisoning
• Periodic paralysis
• Peroneal dystrophy
• Polio
• Spinal cord injury
• Stroke

Home Care

Sudden loss of muscle function is a medical emergency. Seek immediate medical help.

After you have received medical treatment, your doctor may recommend some of the following measures:

• Follow your prescribed therapy.
• If the nerves to your face or head are damaged, you may have difficulty chewing and swallowing or closing your eyes. In these cases, a soft diet may be recommended. You will also need some form of eye protection, such as a patch over the eye while you are asleep.
• Long-term immobility can cause serious complications. Change positions often and take care of your skin. Range-of-motion exercises may help to maintain some muscle tone.
• Splints may help prevent muscle contractures, a condition in which a muscle becomes permanently shortened.

When to Contact a Health Professional

Muscle paralysis always requires immediate medical attention. If you notice gradual weakening or problems with a muscle, get medical attention as soon as possible.

The doctor will perform a physical examination and ask questions about your medical history and symptoms, including:

• Location
  • What part(s) of the body are affected?
  • Does it affect one or both sides of the body?
  • Did it develop in a top-to-bottom pattern (descending paralysis), or a bottom-to-top pattern (ascending paralysis)?
  • Do you have difficulty getting out of a chair or climbing stairs?
  • Do you have difficulty lifting your arm above your head?
  • Do you have problems extending or lifting your wrist (wrist drop)?
  • Do you have difficulty gripping (grasping)?
• Symptoms
  • Do you have pain?
  • Do you have numbness, tingling, or loss of sensation?
  • Do you have difficulty controlling your bladder or bowels?
  • Do you have shortness of breath?
  • What other symptoms do you have?
• Time pattern
  • Do episodes occur repeatedly (recurrent)?
  • How long do they last?
  • Is the muscle function loss getting worse (progressive)?
  • Is it progressing slowly or quickly?
  • Does it become worse over the course of the day?
• Aggravating and relieving factors
  • What, if anything, makes the paralysis worse?
  • Does it get worse after you take potassium supplements by mouth?
  • Is it better after you rest?

Tests that may be performed include:

• Blood studies (such as CBC, white blood cell differential, blood chemistry levels, or muscle enzyme levels)
• CT scan or MRI of the head or spine
• Myelography
• Nerve conduction studies and electromyography
• Muscle or nerve biopsy

Intravenous feeding or feeding tubes may be required in severe cases. Physical therapy, occupational therapy, or speech therapy may be recommended.

Griggs RC, Józefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa. Saunders Elsevier; 2007: chap 418.

Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa. Saunders Elsevier; 2007: chap 447.

Review Date: 2/6/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, CA, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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