A. Acute (days) or subacute (weeks) muscular weakness/paralysis

1. Alcoholic myopathy
2. Botulism
3. Acute spinal or peripheral nerve disease
   a. Acute idiopathic polyneuritis (Guillain Barre syndrome) or other form of polyneuropathy (beriberi, porphyria, etc.)
   b. Poliomyelitis
   c. Rarely polyarteritis nodosa with polyneuropathy
4. Organophosphate poisoning
5. Polymyositis & dermatomyositis
6. Rarely fulminant myasthenia gravis
7. Acute paroxysmal myoglobinuria

B. Episodic muscular weakness

1. Myasthenia gravis
2. Acute thyrotoxic myopathy (also thyrotoxic periodic paralysis)
3. Hyperkalemia or hypokalemia
4. Symptomatic myasthenia of other types: SLE, RA, polymyositis, nonthymic carcinoma
5. Familial periodic paralysis (hypokalemia)
6. Hereditary adynamia (hyperkalemic periodic paralysis)
7. Paramyotonia congenita (von Eulenburg's disease)

C. Chronic (months to years) muscular weakness/paralysis

1. Chronic polymyositis
2. Chronic thyrotoxic & other metabolic myopathies
3. Progressive muscular dystrophy
   a. Duchenne type
   b. Facioscapulohumeral type (Landouzy Dejerine)
   c. Limb girdle type (Erb's & Leyden Moebius)
   d. Distal type (Welander's)
   e. Myotonic dystrophy (Steinert's disease)
   f. Progressive ophthalmoplegic & oculopharyngeal types
4. Chronic neural muscular atrophies
   a. Peroneal muscular atrophy (Charcot Marie Tooth)
   b. Hypertrophic polyneuritis
   c. Amyloid polyneuropathy
   d. Chronic nutritional, arsenical, leprous, & other polyneuropathy.
5. Slowly progressive or relatively stationary polymyopathies
   a. Glycogen storage diseases
   b. Congenital benign hypotonia & congenital universal hypoplasia of muscle
   c. Central core disease, rod body (nemaline) & related polymyopathies.
6. Progressive muscular atrophies & other motor system disease
   a. Amyotrophic lateral sclerosis
   b. Progressive bulbar palsy
   c. Infantile muscular atrophy

Monday,Sep.21, 1998