title: The clinical spectrum of isolated peripheral motor dysfunction.
abstract: BACKGROUND
  Isolated peripheral motor dysfunction due to lower motor neuron or peripheral nerve disorders presents an interesting challenge to clinicians because of the diverse differential diagnosis with a broad range of prognoses.
  
  
  METHODS
  We retrospectively reviewed clinical data of adults who presented over 12 years with muscle weakness, atrophy, or fasciculations, but without hyperreflexia or sensory involvement.
  
  
  RESULTS
  In 119 patients, 52% had a motor neuron disease (MND), 13% had immune neuropathies, 11% had genetic neuronopathies, 10% had residual or post-polio syndrome, 5% had benign fasciculation, 1% had an infectious etiology, and 8% were not given a final diagnosis. Only MND patients had cognitive dysfunction or frontal release signs. Bulbar and respiratory symptoms virtually excluded consideration of immune neuropathy.
  
  
  CONCLUSIONS
  Only half of the patients were diagnosed with MND. A significant minority have treatable conditions. Cognitive involvement, frontal release signs, and bulbar or respiratory symptoms are strongly suggestive of MND.
authors.affiliation: Department of Neurology, Division of Neuromuscular Medicine, The Ohio State University Wexner Medical Center, 395 West 12th Avenue, 7th Floor, Columbus, Ohio, 43210, USA.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Sanderson
authors.forename: W David
authors.initials: WD
authors.lastname: Arnold
authors.forename: Bakri
authors.initials: B
authors.lastname: Elsheikh
authors.forename: John T
authors.initials: JT
authors.lastname: Kissel
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies
keywords: amyotrophic lateral sclerosis; isolated peripheral motor dysfunction; motor neuron disease; multifocal motor neuropathy; progressive muscular atrophy