I suffer from muscle weakness and have a history of Rhabdo. Why is it?

Q. Is it possible for Rhabdo to cause muscle weakness?

Answered by
Dr. Mrinal Kumar Acharya
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 03, 2022 and last reviewed on: Mar 07, 2023

Hi doctor,

I have had muscle weakness for a while. I took an electromyography (EMG) test, which was normal, with no ANA (Antinuclear Antibody). Simple tasks like combing my hair weaken my muscles. I had a history of Rhabdo.



Welcome to icliniq.com.

I understand your concern.

There could be several causes for your muscle weakness. Firstly, one should be able to distinguish it from fatiguability. Do you take any medications regularly? It could be due to myopathy or neuromuscular junction disorder. A thorough neurological clinical examination is necessary. Have you checked your serum CPK (Creatine phosphokinase) level? An electromyography (EMG) that maintains a normal value is possible in neuromuscular junction disorders.

The Probable causes:

Myopathy (metabolic).

Investigations to be done:

Serum CPK (Creatine phosphokinase), repetitive nerve stimulation (RNS) test, and electromyography (EMG).

Differential diagnosis:

Neuromuscular junction disorder.

Probable diagnosis:

Myopathy and neuromuscular junction disorder.

Preventive measures:

Avoid doing heavy exercises and drink plenty of water regularly.

Regarding follow up:

Follow-up after doing the suggested investigation.

Hi doctor,

Thank you for the reply.

I can function normally, but I get tired quickly and then remain sore for longer. I saw a neurologist who performed an EMG (nerve test followed by needles in the leg muscle). I had my CK levels checked several times last year because I had rhabdo, and they were all normal. As a result, no additional tests have been requested by the doctor. However, you have informed me that I may still have a myopathy, so my question is that what other steps can I take to convince the neurologist? Would a muscle biopsy be a better course of action? Please assist. There is no medication, but all of these issues became apparent after a year of taking the tablet Ciprofloxacin.



Welcome back to icliniq.com.

I understand your concern.

Some metabolic myopathies can have normal CPK (Creatine phosphokinase) and electromyography (EMG) levels. Have you had your thyroid function checked? Due to your history of rhabdo, I cannot exclude myopathy from my differential diagnosis. Muscle biopsy is useful for evaluating muscle disorders, but it is an invasive procedure. Therefore, I recommend muscle MRI (magnetic resonance imaging) before muscle biopsy because it can provide a diagnostic clue and help identify a site for muscle biopsy. Above all, you should have a repetitive nerve stimulation (RNS) test to rule out neuromuscular junction disorders such as myasthenia.

Investigations to be done:

Thyroid function test, repetitive nerve stimulation (RNS) test, and muscle MRI (magnetic resonance imaging).

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