Paralysis/Paresis

Last updated: Friday, 24, December, 2010
Key InformationAppropriate Tests

Diagnostic approach dictated by clinical features. Consider likely cause(s) in terms of site of abnormality. CSF examination may be indicated.

Muscle

Myopathy

Neuromuscular junction

Myasthenia

Botulism

Lower motor neurone

Neuropathy

Poliomyelitis

Nerve root compression

Spinal cord compression

See trauma, tumourabscess, below.

Upper motor neurone (cerebral, spinal cord lesions)

Disc prolapse

Infarction

Trauma

Tumour 

Lesion biopsy, including FNAB, if appropriate.

Abscess

Lesion biopsy, FNAB if appropriate: pus - microscopy and culture.

Blood culture.

Motor neurone disease 

Molecular genetics - genetic disorders studies on family members, if the disease is suspected to be familial - consult pathologist.

Multiple sclerosis

HIV infection

Transverse myelitis

Syringomyelia

Inherited degenerative disorders 

  • Spinocerebellar degeneration
  • Leucodystrophies

Enzyme studies or molecular genetics - genetic disorders may be available - consult pathologist.

Subacute combined degeneration of the cord 

See Vitamin B12 deficiency.