-basically to be rolled out when a more global presentation of weakness, paresthesias where DDx might include polyneruopathy, ALS, myastenia, myopathy
- Dysphonia/Dysarthria (noticed any change in voice/speach)
- Dysphagia (choking on foods, coughing at meal times, last one to finish eating at a family dinner)
- Diplopia (blurry/double vison – especially with reading, watching TV, driving = sustained gaze)
- Muscle twitches (fasciculations) – demonstrate for patient how an isolated muscle moves
- Exercise tolerance – taken through exercise history. What done for exercise? How different now vs. before. Has this gone down?
- Myalgia (exertional)
- Cramps (like a “charlie horse”) – during the day or nocturnal only?
- Weakness (differentiate from pain)
- Legs (e.g. going up and down stairs, getting out of chairs, able to jog)
- Arms (e.g. take a stack of dishes and put them on the top shelf)
- Muscle (not mental) fatigue – variant question on exercise tolerance. If they do have muscle fatigue does it get better after a brief rest?
- Pigmenturia – has urine ever turned brown or black like tea or coke
- Myotonia – cramp in your hands where it is hard to let go of something
- Balance – tripping or falling more than usual? Had any falls in the last months?
- Paresthesia(tingling) , Numbness – hands, feet, timing
- Burning/shooting pain
- Erectile dysfcn
- Postural hypotension
- Hypo/hyperhydrosis – changes in the way you sweat? very sweaty or very dry skin?
- Dry eyes (dry to the point it feels like something is in your eye?)
- Dry mouth
- Bladder (retention/urgency/incontinence)
- Bowel (severe constipation/incontinence)
- Cardiovascular complaints
- Systemic B symptoms