Table 3 Neurologic topographic localization and respective clinical signs (modified from Bertorini 2022)
From: Essential neuromuscular advice for pathologists (first of two parts)
Clinical sign | Pattern of weakness | Fasciculations | Deep tendon reflexes | Sensory loss |
|---|---|---|---|---|
Motor Neuron Disease | Variable, symmetric in most, often asymmetric in amyotrophic lateral sclerosis | yes | decreased or absent | no |
Polyneuropathy | distal > proximal | sometimes | decreased or absent | usually present |
Myopathy | proximal > distal | no | normal initially, may be decreased in later stages (ankle reflexes often preserved until very late) | no |
Neuromuscular junction disorder | proximal distal in most; fluctuates; often involves extraocular muscles | no | normal in postsynaptic disorders (myasthenia gravis), decreased in presynaptic disorders (Eaton-Labert syndrome and botulism) | no |