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Neuro Muscular Disorder





Proximal muscle weakness and wasting

Except – Myotonic muscular dystrophy

Distal muscle weakness and wasting

Except spinal muscular atrophy (SMA)


Deep tendon reflex – present

Deep tendon reflex – absent


Fasciculation absent

Fasciculation present


Sensory abnormalities generally absent

Sensory abnormalities – present


Muscle pain myalgia present

Except Muscular trophies

Muscular pain myalgia present

Except SMA


Laboratory findings

  1. Serum enzyme: CPK, LDH, SGOT all increase
  2. Nerve conduction velocity: Neuropathies of various types are detected by decreased conduction. 80% of the total nerve fibers must be involved before slowing in conduction is detected.
  3. EMG: Less useful in pediatrics than in adult medicine EMG more specific than biopsy in diagnosis of Myasthenia gravis.
  4. Muscle Biopsy: Muscle biopsy is the most important and specific diagnostic study of muscle. The vastus lateralis is the muscle most commonly sampled. Q The deltoid muscle should be avoided in most of the cases.
  5. Nerve Biopsy: The most commonly sampled nerve is the sural nerveQ. It is a pure sensory nerve and 90% regenerated when severed behind the lateral malleolus of the ankle.

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