neuromyopathy

Neuromyopathy is a broad, non-specific term used to describe disorders in which both the nervous system and the skeletal muscle are affected. The presentation can reflect a spectrum in which neuropathic and myopathic processes overlap, or a single disease with mixed features. Neuromyopathy may result from a variety of etiologies, including congenital and inherited neuromuscular disorders, autoimmune or inflammatory diseases, metabolic or endocrine abnormalities, toxic exposures, infections, and complications of critical illness.

Common clinical features include weakness that may be proximal or distal, fatigue, and difficulty with activities such as climbing stairs, rising from a chair, or gripping. Reflexes may be reduced or lost; sensory symptoms such as numbness or tingling can occur if peripheral nerves are involved. Electrophysiologic testing often reveals a combination of neurogenic changes (fibrillations, reduced recruitment) and myopathic changes (shorter motor unit potentials, early recruitment), reflecting mixed pathology.

Evaluation aims to identify the pattern and cause. Tests include nerve conduction studies and electromyography, serum creatine kinase, inflammatory markers, metabolic panels, autoimmune screens, imaging, and sometimes muscle or nerve biopsy. Genetic testing is used when a hereditary neuromuscular disorder is suspected. Determining the primary or dominant process guides treatment decisions and prognosis.

Management focuses on treating the underlying condition when possible, along with supportive care such as physical and occupational therapy, nutritional optimization, management of complications, and monitoring for progression. Treatment may involve immunotherapies for inflammatory or autoimmune causes, avoidance of toxins, and symptomatic therapies for pain and fatigue. Prognosis depends on the etiology and the extent of nerve and muscle involvement.