The neuromuscular system consists of the peripheral nerves, neuromuscular junction, and muscles.

Common clinical signs of neuromuscular dysfunction:

Motor neuropathy

  • Flaccid paresis / paralysis
  • Reduced/absent spinal nerve reflexes
  • Postural reaction deficits
  • Decreased muscle tone
  • Denervation muscle atrophy

Sensory neuropathy

  • Decreased/absent spinal nerve & withdrawal reflexes, usually without muscle atrophy
  • Postural reaction deficits
  • Decreased pain response
  • Self-mutilation
  • Abnormal sensation/sensitivity (paraesthesia) of face, trunk or limbs
  • Autonomic neuropathy (alone or in combo with above)
    • Anisocoria or dilated pupils
    • Decreased tear production
    • Decreased salivation
    • Bradycardia


  • Generalized weakness
  • Exercise intolerance
  • Stiff, stilted gait
  • Localized or generalized muscle atrophy
  • Generalized muscle hypertrophy
  • Dimple contracture
  • Painful response to muscle palpation
  • Limited joint movement (contracture)