Otherwise, electromyography is indicated to confirm the presence of a myopathy or to evaluate for a neuropathy or a disease of the neuromuscular junction. If a specific cause of weakness is suspected, the appropriate laboratory or radiologic studies should be performed. In the physical examination, the physician should objectively document the patient’s loss of strength, conduct a neurologic survey, and search for patterns of weakness and extramuscular involvement. The pattern and severity of weakness, associated symptoms, medication use, and family history help the physician determine whether the cause of a patient’s weakness is infectious, neurologic, endocrine, inflammatory, rheumatologic, genetic, metabolic, electrolyte-induced, or drug-induced. Diagnosis begins with a patient history distinguishing weakness from fatigue or asthenia, separate conditions with different etiologies that can coexist with, or be confused for, weakness. Muscle weakness is a common complaint among patients presenting to family physicians.
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