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Acute muscle weakness or neuromuscular weakness in children

Acute muscle weakness or neuromuscular weakness in children is a sign of a pediatric emergency. When the childcare specialist is making a diagnosis, you need to give them your child’s detailed history including but not limited to family history, the onset of weakness, immunizations, ingestion of toxins or toxic substances, and history of associated febrile states. At the Rainbow Children’s Hospital, we conduct a thorough neurological examination that can help in determining the underlying condition causing the acute general weakness. Services At the Rainbow Children’s Hospital, we provide the following child care services for helping your child deal with acute general weakness or neuromuscular weakness: Electrodiagnostic testing Orthotics Medical and rehabilitation supplies Physical, medical, and occupational therapy Nutritional and respiratory care Social work services Wheelchair evaluations FAQs

1. What is Neuromuscular Electrodiagnostic Testing? This test is used for establishing a diagnosis for disorders that affect muscles and nerves. They also help in distinguishing between issues of the central nervous system from the issues caused by the peripheral nerves. In this diagnostic testing, the following tests are included:

Autonomic testing Electromyography Nerve conduction studies Quantitative sensory evaluation Repetitive nerve stimulation Single fiber EMG Ultrasound (muscle and nerve) 2. What are the most common neuromuscular disorders that can lead to acute general weakness? Here are the most common neuromuscular disorders that can cause acute general weakness or neuromuscular weakness:

ALS-Lou Gehrig’s disease Amyotrophic Lateral Sclerosis or the Lou Gehrig is a progressive neurodegenerative disease affective the nerve cells in the spinal cord and the brain. The life expectancy of a child with ALS averages 2 to 5 years from the diagnosis. However, there are some people that can live a quality life for more than 5 years. About 20 percent of people with ALS live for 5 or more years. Only 5 percent of them get to lie up to 20 years. In some cases, the ALS stops progressing. In others, it reverses. There are no ethnic, racial, or socioeconomic boundaries for ALS. It can occur to anyone. Muscular Dystrophy This is a group containing more than 30 genetic diseases. All of these conditions can be characterized by the degeneration and weakness of the skeletal muscles that are responsible for controlling movement. In some cases, forms of muscular dystrophy can be seen in infants and children. In others, it might not appear until middle age or later. All the disorders of the muscular dystrophy differ in terms of extent and distribution of muscle weakness, rate of regression, the pattern of inheritance, and age of onset. Myasthenia Gravis This is a chronic autoimmune neuromuscular disease that can be characterized by the changing degree of weakness of the body’s voluntary muscles, especially while doing an activity. However, with some rest, this can be improved. For the majority of children with myasthenia gravis, life expectancy is normal; thanks to the current therapies. Muscles that are usually affected by this condition are the ones that control eyelid and eye movement, chewing, swallowing, talking, and facial expression. In rare cases, the muscles controlling breathing, limb, and neck movements are also affected. 3. What are the causes behind neuromuscular or acute general weakness? General weakness can occur when you perform strenuous physical activities like taking a long hike. Soon, you will start feeling tired and weak, and your muscles will start to get sore. However, this sensation goes away in a few days. In some cases, however, generalized muscle weakness can be because of any underlying condition including the following:

Infections like respiratory infection or urinary tract infection. Issues with the electrolytes or minerals that are found in the body naturally such as low levels of sodium and potassium. Problems with the thyroid gland which is responsible for regulating the way energy is used by the body. Hypothyroidism or low thyroid level can result in weakness, fatigue, weight gain, lethargy, memory problems, depression, brittle nails, thinning and coarse

hair, constipation, dry skin, yellowish tint to the skin, and intolerance to cold. Hyperthyroidism or a high thyroid level can result in weight loss, fatigue, increased heart rate, sweating, anxiety, thyroid enlargement, muscle weakness,

irritability, and intolerance to heat. Guillain-Barre syndrome is a nerve disorder that results in weakness in the arms, legs and other muscles. Slowly, it can progress to complete paralysis. Myasthenia gravis is another rare, chronic disorder responsible for causing rapid muscle fatigue and weakness.

If your child’s muscle weakness is getting worse, you should contact a neurologist immediately. Loss of function and sudden muscle weakness in an area of the body can mean that there is a serious issue with the brain (like a transient ischemic attack or a stroke), spinal cord, or a nerve. 4. What are the symptoms of neuromuscular disorders? Neuromuscular disorders can often result in fatigue and muscle weakness that gets worse over time. Some of these conditions start to show symptoms in infancy, while in others the symptoms may appear in childhood or adulthood. The type of neuromuscular disorder and the affected areas of the body will determine the symptoms. Here are some common symptoms:

Balance problems Double vision Droopy eyelids Movement issues Muscle loss Muscle weakness leading to cramps, aches, twitching, and pain Numbness, painful, and tingling sensations Trouble breathing Trouble swallowing

5. How important is the early diagnosis for treating neuromuscular or acute general weakness? The main cause behind neuromuscular and acute general weakness is neuromuscular disorders. They can put a great amount of emotional and financial burden on the children and their families. Early identification can help in relieving stress and ensuring that your child gets appropriate services and management. In some cases, early initiation of treatment can improve outcomes and even slow disease progression. If your baby has such a condition, you can try genetic counseling for making decisions regarding future pregnancies. Screening and surveillance are key components in treating pediatric-neurology disorders.

Dr. Prasanthi Aripirala

Consultant Pediatric Neurologist & Epileptologist

Rainbow Children's Hospital, Hydernagar