What are the distinguishing features on clinical examination between a neuropathy and a myopathy?

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College Answer

Neuropathy

Myopathy

Site of weakness

Distal weakness

Usually proximal

Sensory

May have concomitant sensory symptoms and signs

Usually pure motor

Reflexes

Reflexes lost early

Reflexes   preserved   till late

Fasciculations

Fasciculations   may   be
present

Not typical

Contractures

Contractures       not       a
feature

Contractures present

Myocardial dysfunction

Not a typical feature

May                         have
accompanying cardiac dysfunction with the dystrophies

Discussion

This question closely resembles Question 14.1 from the first paper of 2013.

This college answer is slightly different, and better organised.

References

Chapter   57   (pp. 617)  Neuromuscular  diseases  in  intensive  care by George  Skowronski  and  Manoj  K  Saxena

 

UpToDate: An approach to the patient with muscle weakness

 

Young, G. Bryan, and Robert R. Hammond. "A stronger approach to weakness in the intensive care unit." Critical care 8.6 (2004): 416.