1. NEUROLOGIC CAUSES
1.1. Patterns & Etiologies of Neurologic Weakness
1.1.1. Quadriplegia / Paresis
1.1.1.1. Brain Involvement - eg: Bilateral CVAs
1.1.1.2. Spinal Cord Lesions Cephalad to T1
1.1.2. Paraplegia / Paresis
1.1.2.1. Brain Causes of Paraplegia
1.1.2.1.1. Cerebral Palsy Diplegia
1.1.2.1.2. ParaSaggital Meningioma
1.1.2.1.3. Thrombosis of the Un-paired Anterior Cerebral Artery
1.1.2.1.4. Thrombosis of the Superior Saggital Sinus
1.1.2.1.5. Hydrocephalus
1.1.2.2. Spinal Cord Causes
1.1.2.2.1. Traumatic
1.1.2.2.2. Tumors
1.1.2.2.3. Infectious
1.1.2.2.4. Nutritional
1.1.2.2.5. Developmental
1.1.2.2.6. Others
1.1.2.3. Lower Motor Neuron Causes
1.1.2.3.1. Guillain-Barre' Syndrome
1.1.2.3.2. Anterior Poliomyelitis
1.1.2.3.3. Cauda-Equina Syndrome
1.1.2.3.4. Others
1.1.2.4. Muscle Causes
1.1.2.4.1. Myopathies - limb-girdle type
1.1.2.5. NO CAUSE
1.1.3. Hemiplegia / Paresis
1.1.3.1. Cerebral Ischemia
1.1.3.1.1. Thrombo-embolic event
1.1.3.1.2. Vascular Spasms of variable etiology
1.1.3.2. Cerebral Hemorrhage
1.1.3.2.1. Usually massive CVAs with Severe outcomes
1.1.3.3. Brown-sequard Syndrome (Spinal Cord)
1.1.3.3.1. Some form of sharp injury to the Spinal Cord
1.1.4. Monoplegia / Paresis
1.1.4.1. Isolated Root or Proximal Nerve Palsy
1.1.4.1.1. Classification of Peripheral Nerve Injuries by Anatomic Changes
1.1.5. Isolated Plegias / Paresis
1.2. HOW to DDx a NEUROLOGIC Dx
1.2.1. Whole Body Weakness of Neurologic Origin
1.2.1.1. Check Quadriplegia Causes
1.2.2. Unilateral Weakness - Both Upper & Lower Limbs
1.2.2.1. Check for Hemiplegic Causes
1.2.3. Monoparesis
1.2.3.1. Usually Peripheral Nerve injuries - Look for History
1.2.3.1.1. Birth related Plexopathies
1.2.3.1.2. Compression related Plexopathy
1.2.3.1.3. Compression related Neuropathy
1.2.3.1.4. Massive Trauma related Plexopathy
1.2.3.1.5. Surgical Trauma
1.2.3.1.6. Others
1.2.4. Patchy Loss of Muscle Strength w/or w/out sensation
1.2.4.1. THIS IS A SIGN OF NEUROPATHY
1.2.4.1.1. Correlate with Diabetes
1.2.4.1.2. Correlate with Chemotherapy
2. DISUSE & DECONDITIONINING
2.1. Disease
2.2. Paralysis
2.3. Prolonged Bed Rest - Hospitalizations
2.4. Aging
2.5. Behavioral
2.6. Others ?
3. METABOLIC CAUSES
3.1. Electrolyte imbalance
3.1.1. Renal Disease
3.1.2. Liver Disease
3.1.3. Others
3.2. Nutritional causes
3.2.1. Vitamin B12 Deficiiency
3.2.1.1. Megaloblastic Anemia
3.2.1.2. Subacute Combined Degeneration of the Spinal Cord (SACD)
3.2.2. Others
4. CARDIOVASCULAR CAUSES
4.1. Neurologic Compromise due to complete loss of blood supply to central or peripheral nervous system
4.2. Loss of Cardiovascular Endurance
4.2.1. Myocardial Injury
4.2.1.1. Acute Coronary Syndrome (ACS)
4.2.1.1.1. STEMI
4.2.1.1.2. NSTEMI
4.2.1.1.3. Unstable Angina
4.2.2. Myocardial Muscle deterioration
4.2.2.1. CHF
4.2.2.2. Cardiomyopathies
4.2.2.3. Takatsubo Syndrome
4.2.3. Loss of Blood Flow
4.2.3.1. Valvular Heart Disorders
4.2.3.1.1. Valve Stenosis
4.2.3.1.2. Valve regurgitation
4.2.3.2. Severe Hypertension
4.3. Inability to Provide O2 Transport
4.3.1. Hematologic Diseases
4.3.1.1. Anemias
4.3.1.2. Leukemias
4.3.1.3. Multiple Myeloma
4.4. Reduction in Tissue Perfusion
4.4.1. Hypotension & Shock
5. Weakness secondary to Pain Inhibition
5.1. Degenerative Disorders (Orthopedic & Autoimmune)
5.1.1. Osteoarthritis
5.1.2. Rheumatoid arthritis
5.2. Infectious Disease
5.2.1. Rheumatic fever
5.2.2. Septic arthritis
5.3. Surgical Pain with reduced effort
6. Back to Common Consults for Physical Therapists
7. PULMONARY CAUSES
7.1. Lack of adequate Oxygenation
7.1.1. Respiratory Failure
7.1.1.1. Toxic
7.1.1.2. COPD
7.1.1.3. Asthma
7.1.1.4. Inhalation injuries
7.1.1.5. Interstitial Lung Disease
7.1.1.5.1. Occupational
7.1.1.5.2. Idiopathic Lung Fibrosis
7.1.1.6. Others
8. PSYCHOLOGICAL CAUSES
8.1. Confusional States
8.1.1. Delirium (Acute Confusion)
8.1.2. Dementia (Chronic Confusion)
8.2. Major Neuropsychiatric Disorders
8.2.1. Refusal to Participate
8.2.2. Unable to follow commands