Proximal Weakness

This article is a stub.

Classification

Proximal Weakness

Myopathic

Non-Myopathic

Acquired

Genetic

Inflammatory myositis Polymyositis dermatomyositis immune mediated necrotising myopathy Endocrine - e.g cushings, dysthyroid Drugs Hyper/hypokalaemia

Becker's or Duchenne's muscular dystrophy Limb girdle muscle dystrophies Congenital myopathies Mitochondrial Metabolic (glycogen or lipid disorder) Acid maltase

Peripheral neuropathies with proximal weakness - vasculitis or CIDP Plexopathies e.g. diabetic amyotrophy Infiltration nerve root - neoplastic meningitis Myelopathy Neuromuscular junction - Lambert Eaton myaesthenic syndrome Anterior horn cell - spinal muscular atrophies if chronic, motor neuron disease if subacute and progressive

Examination

Gower's sign.

Gower's sign is a physical finding used to assess for proximal lower limb muscle weakness particularly in those with certain neuromuscular disorders.

To perform the Gower's sign test, the patient is asked to rise from a sitting or lying position on the floor without using their hands or arms for support. Patients with normal muscle strength are able to perform this task with ease. However, patients with proximal lower limb muscle may use their hands and arms to "climb up" their own body, pushing against their thighs, hips, and abdomen to achieve a standing position. This maneuver is often accompanied by compensatory movements, such as hyperextension of the knees or lordosis of the lumbar spine.