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Gradual muscle weakness can be a symptom for many medical conditions some of them are serious and untreatable conditions. I want to take a moment here to remind the reader that sudden muscle weakness is a red flag for stroke which is a treatable emergency!

Gradual muscle weakness can be very subtle at the beginning that it can take the patient a while to visit a doctor. I had a patient who came to the clinic with weakness symptoms started 6 months ago, but because the onset was gradual and the progression was slow the patient thought he was just tired and didn't seek medical help for 6 months and when finally did his disease was so progressed that it was very difficult to treat. Although muscle weakness could be a consequence of a long working day or dehydration it is often a symptom for a more serious condition.

What causes weak muscles?

  • Myasthenia gravis. Also starts with weakness and rapid fatigue and can affect any muscle but usually it starts with muscles of face, eyes and neck. Myasthenia gravis also caused by your immune system attacking your own body (autoimmune) particularly the damaged location is the communication between nerves and muscles. Myasthenia gravis can affect patients of any age, especially females younger than 40 and males older than 60.
  • Amyotrophic lateral sclerosis. Or ALS (often called Lou Gehrig's disease) is one of the most serious neurological conditions that cause weak muscles and disability. There is no known cure for ALS, medicine only helps relieving some of the symptoms, but most cases progress over a few years and end up eventually with death. The first symptoms of ALS usually are muscle twitching and muscle weakness (especially hands and feet). These soon will be accompanied with difficulty of speaking (slurring of speech). ALS progresses over the course of few years to affect the ability to move, eat and eventually even breathe.
  • Guillain-Barre syndrome. This syndrome usually follows an infection. The immune system while trying to fight the infection it might damage some other parts of your body (this is called autoimmune). Guillain-Barre syndrome occurs when the immune system attacks the nerves. Usually it starts with weakness and tingling in both legs. The weakness spreads quickly and eventually the whole body is paralyzed. Most patients completely recover from Guillain-Barre syndrome. Medical help is essential during the acute phase of the disease because the disease can progress to affect the muscles responsible for breathing.
  • Hyperparathyroidism. Symptoms are so mild and nonspecific and that's why this condition is usually diagnosed with blood tests and laboratory results. Symptoms include; Easy fractures with minimal trauma, kidney stones, excessive thirst and urination, depression, forgetfulness and muscle weakness.
  • Carnitine deficiency. Very rare condition
  • Myotonic Dystrophy.
  • Spinal Muscular Atrophy.

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