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Published on: January 12, 2019
Acute muscular weakness in children
Ricardo Pablo Javier Erazo Torricelli1,2
1Hospital Luis Calvo Mackenna, Provencia, Santiago, Chile.
Insights
Acute muscle weakness in children requires prompt diagnosis. This review details common causes, diagnostic clues like hyperCKemia and hypokalemia, and emphasizes timely treatment for better outcomes in pediatric emergencies.
Area of Science:
- Pediatric Neurology
- Clinical Medicine
Background:
- Acute muscle weakness is a critical pediatric emergency.
- A thorough diagnostic approach is essential for timely intervention.
Purpose of the Study:
- To review common causes of acute muscle weakness in children.
- To guide diagnostic strategies based on clinical presentation and laboratory findings.
Main Methods:
- Systematic review of diseases causing acute muscle weakness.
- Classification of disorders by anatomical site of origin (upper motor neuron to motor unit).
- Highlighting key diagnostic indicators such as hyperCKemia, hypokalemia, and specific neurological signs.
Main Results:
- Common causes include Guillain-Barré syndrome (distal weakness, hyporeflexia), myasthenia gravis/botulism (ophthalmoparesis, ptosis, bulbar signs), myositis (hyperCKemia), and periodic paralysis (hypokalemia).
- A normal study workup may suggest a psychogenic cause.
- Early identification of the etiology is crucial for effective treatment.
Conclusions:
- Accurate diagnosis of acute pediatric muscle weakness relies on detailed history and neurological examination.
- Specific clinical and laboratory findings aid in differentiating various etiologies.
- Timely diagnosis and treatment significantly improve prognosis in affected children.
Abstract:
Acute muscle weakness in children is a pediatric emergency. During the diagnostic approach, it is crucial to obtain a detailed case history, including: onset of weakness, history of associated febrile states, ingestion of toxic substances/toxins, immunizations, and family history. Neurological examination must be meticulous as well. In this review, we describe the most common diseases related to acute muscle weakness, grouped into the site of origin (from the upper motor neuron to the motor unit). Early detection of hyperCKemia may lead to a myositis diagnosis, and hypokalemia points to the diagnosis of periodic paralysis. Ophthalmoparesis, ptosis and bulbar signs are suggestive of myasthenia gravis or botulism. Distal weakness and hyporeflexia are clinical features of Guillain-Barré syndrome, the most frequent cause of acute muscle weakness. If all studies are normal, a psychogenic cause should be considered. Finding the etiology of acute muscle weakness is essential to execute treatment in a timely manner, improving the prognosis of affected children.
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