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Acute non-traumatic tetraparesis : differential diagnosis

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Resumo:Introduction: Potentially life-threatening disorders may present in the emergency department with acute tetraparesis, and their recognition is crucial for an appropriate management and timely treatment. Our review aims to systematize the differential diagnosis of acute non-traumatic tetraparesis. Results: Causes of tetraparesis can be classified based on the site of defect: upper motor neuron (UMN), peripheral nerve, neuromuscular junction or muscle. History of present illness should include the distribution of weakness (symmetric/asymmetric or distal/proximal/diffuse) and associated clinical features (pain, sensory findings, dysautonomia, and cranial nerve abnormalities such as diplopia and dysphagia). Neurological examination, particularly tendon reflexes, helps further in the localization of nerve lesions and distinction between UMN and lower motor neuron. Ancillary studies include blood and cerebral spinal fluid analysis, neuroaxis imaging, electromyography, muscle magnetic resonance and muscle biopsy. Conclusions: Acute tetraparesis is still a debilitating and potentially serious neurological condition. Despite all the supplementary ancillary tests, the neurological examination is the key to achieve a correct diagnosis. The identification of life-threatening neurologic disorders is pivotal, since failing to identify patients at risk of complications, such as acute respiratory failure, may have catastrophic results.
Autores principais:Oliveira, Renato
Outros Autores:Ramalho Rocha, Filipa; Teodoro, Tomás; Oliveira Santos, Miguel
Assunto:Acute tetraparesis Brainstem stroke Myelopathy Myopathy Neuromuscular junction disorder Polyneuropathy
Ano:2021
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso restrito
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa
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author Oliveira, Renato
author2 Ramalho Rocha, Filipa
Teodoro, Tomás
Oliveira Santos, Miguel
author2_role author
author
author
author_facet Oliveira, Renato
Ramalho Rocha, Filipa
Teodoro, Tomás
Oliveira Santos, Miguel
author_role author
contributor_name_str_mv Repositório Científico de Acesso Aberto da ULisboa
country_str PT
creators_json_txt [{\"Person.name\":\"Oliveira, Renato\",\"Person.identifier.orcid\":\"0000-0003-1181-1418\"},{\"Person.name\":\"Ramalho Rocha, Filipa\"},{\"Person.name\":\"Teodoro, Tomás\"},{\"Person.name\":\"Oliveira Santos, Miguel\",\"Person.identifier.orcid\":\"0000-0002-8290-0410\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
datacite.creators.creator.creatorName.fl_str_mv Oliveira, Renato
Ramalho Rocha, Filipa
Teodoro, Tomás
Oliveira Santos, Miguel
datacite.date.Accepted.fl_str_mv 2021-01-01T00:00:00Z
datacite.date.available.fl_str_mv 2021-09-10T15:10:27Z
datacite.date.embargoed.fl_str_mv 2021-09-10T15:10:27Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_16ec
datacite.subjects.subject.fl_str_mv Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
datacite.titles.title.fl_str_mv Acute non-traumatic tetraparesis : differential diagnosis
dc.contributor.none.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
dc.creator.none.fl_str_mv Oliveira, Renato
Ramalho Rocha, Filipa
Teodoro, Tomás
Oliveira Santos, Miguel
dc.date.Accepted.fl_str_mv 2021-01-01T00:00:00Z
dc.date.available.fl_str_mv 2021-09-10T15:10:27Z
dc.date.embargoed.fl_str_mv 2021-09-10T15:10:27Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10451/49501
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_16ec
dc.subject.none.fl_str_mv Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
dc.title.fl_str_mv Acute non-traumatic tetraparesis : differential diagnosis
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Introduction: Potentially life-threatening disorders may present in the emergency department with acute tetraparesis, and their recognition is crucial for an appropriate management and timely treatment. Our review aims to systematize the differential diagnosis of acute non-traumatic tetraparesis. Results: Causes of tetraparesis can be classified based on the site of defect: upper motor neuron (UMN), peripheral nerve, neuromuscular junction or muscle. History of present illness should include the distribution of weakness (symmetric/asymmetric or distal/proximal/diffuse) and associated clinical features (pain, sensory findings, dysautonomia, and cranial nerve abnormalities such as diplopia and dysphagia). Neurological examination, particularly tendon reflexes, helps further in the localization of nerve lesions and distinction between UMN and lower motor neuron. Ancillary studies include blood and cerebral spinal fluid analysis, neuroaxis imaging, electromyography, muscle magnetic resonance and muscle biopsy. Conclusions: Acute tetraparesis is still a debilitating and potentially serious neurological condition. Despite all the supplementary ancillary tests, the neurological examination is the key to achieve a correct diagnosis. The identification of life-threatening neurologic disorders is pivotal, since failing to identify patients at risk of complications, such as acute respiratory failure, may have catastrophic results.
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language eng
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organization_str_mv urn:organizationAcronym:ul
person_str_mv Oliveira, Renato
Oliveira, Renato
http://orcid.org/0000-0003-1181-1418
0000-0003-1181-1418
Ramalho Rocha, Filipa
Teodoro, Tomás
Oliveira Santos, Miguel
Oliveira Santos, Miguel
https://www.ciencia-id.pt/B511-DD32-12D7
B511-DD32-12D7
http://orcid.org/0000-0002-8290-0410
0000-0002-8290-0410
publishDate 2021
publisher.none.fl_str_mv Elsevier
reponame_str Repositório da Universidade de Lisboa
repository_id_str urn:repositoryAcronym:ul
service_str_mv urn:repositoryAcronym:ul
spelling engElsevierpt_PTIntroduction: Potentially life-threatening disorders may present in the emergency department with acute tetraparesis, and their recognition is crucial for an appropriate management and timely treatment. Our review aims to systematize the differential diagnosis of acute non-traumatic tetraparesis. Results: Causes of tetraparesis can be classified based on the site of defect: upper motor neuron (UMN), peripheral nerve, neuromuscular junction or muscle. History of present illness should include the distribution of weakness (symmetric/asymmetric or distal/proximal/diffuse) and associated clinical features (pain, sensory findings, dysautonomia, and cranial nerve abnormalities such as diplopia and dysphagia). Neurological examination, particularly tendon reflexes, helps further in the localization of nerve lesions and distinction between UMN and lower motor neuron. Ancillary studies include blood and cerebral spinal fluid analysis, neuroaxis imaging, electromyography, muscle magnetic resonance and muscle biopsy. Conclusions: Acute tetraparesis is still a debilitating and potentially serious neurological condition. Despite all the supplementary ancillary tests, the neurological examination is the key to achieve a correct diagnosis. The identification of life-threatening neurologic disorders is pivotal, since failing to identify patients at risk of complications, such as acute respiratory failure, may have catastrophic results.application/pdfpt_PTAcute non-traumatic tetraparesis : differential diagnosisPersonalOliveira, RenatoDSpacehttp://dspace.org/items/f6e18ce3-9afb-4e50-ac17-687f8ac23aa5DSpacehttp://dspace.org/items/f6e18ce3-9afb-4e50-ac17-687f8ac23aa5OliveiraRenatoORCIDhttp://orcid.org0000-0003-1181-1418Ramalho Rocha, FilipaTeodoro, TomásPersonalOliveira Santos, MiguelDSpacehttp://dspace.org/items/eab02009-54a9-4518-8b22-9426433cea69DSpacehttp://dspace.org/items/eab02009-54a9-4518-8b22-9426433cea69Oliveira SantosMiguelCiência IDhttps://www.ciencia-id.ptB511-DD32-12D7ORCIDhttp://orcid.org0000-0002-8290-0410Scopus Author IDhttps://www.scopus.com57217474349HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf0967-5868DOIIsPartOf10.1016/j.jocn.2021.02.0242021-09-10T15:10:27Z20212021-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/49501http://purl.org/coar/access_right/c_16ecrestricted accessAcute tetraparesisBrainstem strokeMyelopathyMyopathyNeuromuscular junction disorderPolyneuropathy499779 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_16ecapplication/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/20734810-c594-4b90-8d85-5e356aaf906d/downloadJournal of Clinical Neuroscience87116124
spellingShingle Acute non-traumatic tetraparesis : differential diagnosis
Oliveira, Renato
Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
status SINGLETON
subject.fl_str_mv Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
title Acute non-traumatic tetraparesis : differential diagnosis
title_full Acute non-traumatic tetraparesis : differential diagnosis
title_fullStr Acute non-traumatic tetraparesis : differential diagnosis
title_full_unstemmed Acute non-traumatic tetraparesis : differential diagnosis
title_short Acute non-traumatic tetraparesis : differential diagnosis
title_sort Acute non-traumatic tetraparesis : differential diagnosis
topic Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
topic_facet Acute tetraparesis
Brainstem stroke
Myelopathy
Myopathy
Neuromuscular junction disorder
Polyneuropathy
url http://hdl.handle.net/10451/49501
visible 1