Schubert Kai Michael, Schreiner Bettina
Klinik für Neurologie, Universitätsspital Zürich.
Praxis (Bern 1994). 2023 Jul;112(9):459-468.
Muscle weakness is a common symptom in the general practice. The diagnostic work-up starts with distinguishing true muscle weakness from fatigue. The localization, time course and severity of muscle weakness as well as associated symptoms, concomitant diseases, medication and family history can help classify the weakness into certain main categories. These are genetic, inflammatory, infectious, neoplastic, toxic and metabolic/endocrine causes. Further laboratory investigations, ENMG, MRI, muscle biopsy and genetic testing can help to further narrow the differential diagnosis. Due to recent advances, particularly in the field of genetics and targeted immunomodulatory therapies, a growing number of diseases which present with muscular weakness can be treated successfully.
肌肉无力是全科医疗中常见的症状。诊断性检查首先要将真正的肌肉无力与疲劳区分开来。肌肉无力的部位、病程、严重程度以及相关症状、伴随疾病、用药情况和家族史有助于将肌无力归类为某些主要类型。这些类型包括遗传、炎症、感染、肿瘤、中毒和代谢/内分泌原因。进一步的实验室检查、神经肌肉电图、磁共振成像、肌肉活检和基因检测有助于进一步缩小鉴别诊断范围。由于最近的进展，特别是在遗传学和靶向免疫调节治疗领域，越来越多表现为肌无力的疾病能够得到成功治疗。
