RT Book, Section A1 Kang, Peter B. A1 Darras, Basil T. A2 Kline, Mark W. SR Print(0) ID 1182923848 T1 General Evaluation of Strength, Tone, and Sensation T2 Rudolph's Pediatrics, 23e YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9781259588594 LK accesspediatrics.mhmedical.com/content.aspx?aid=1182923848 RD 2024/03/28 AB Disorders of the peripheral nervous system generally can be divided into 3 major anatomic categories: (1) neurogenic disorders, including motor neuron diseases; (2) disorders of the neuromuscular junction; and (3) myopathies, including muscular dystrophies. History and physical examination remain critical in focusing the differential diagnosis of neuromuscular diseases. Polyneuropathies typically present with distal weakness and atrophy (manifesting as foot drop), loss of deep tendon reflexes, and sensory deficits. Children with chronic polyneuropathies, especially Charcot-Marie-Tooth disease, may be unaware of sensory loss. Motor neuron disease such as spinal muscular atrophy will cause proximal or generalized weakness. Disorders of the neuromuscular junction are sometimes difficult to diagnose in children. Infant botulism typically begins with constipation, followed by a descending pattern of weakness. Juvenile myasthenia gravis may present with a variety of symptoms, including fatigue, but this disorder is almost always accompanied by ocular or bulbar deficits. Myopathies tend to cause proximal or generalized weakness. Neither neuromuscular junction disorders nor myopathies are accompanied by sensory loss, although myalgias may be present in the latter.