Muscular Weakness, Proximal

Abstract

Bilateral proximal muscular weakness of insidious onset should arouse suspicion primarily of myopathy. In the initial stage of myopathy, weakness disproportionate to the mild degree of muscular atrophy develops. There is no fasciculation of muscle fibers, and reflexes are normal or only slightly attenuated. Of course, there are no paresthesias, nor is there any sensory deficit. The patients may report pain on muscular exercise that suggests widespread affection of the respective muscles, to the extent that the natural alternation between working and resting portions of the muscle(s) no longer functions.