Weakness
Muscle movement is the consequence of an intricate series of steps starting in the brain with electrical signals passed down the spinal cord and into nerves. The nerves form a junction in the muscle and send chemical signals to make it move. Weakness can be caused by diseases in any part of this pathway from the brain to muscles themselves. Neurologists treat people with any of the wide range of c
What it is
Localisation drives investigation: upper motor neurone (brain or spinal cord), lower motor neurone (anterior horn cell, root, plexus or nerve), neuromuscular junction (myasthenia, Lambert-Eaton), or muscle (myositis, myopathy). Detailed examination plus targeted nerve conduction, EMG, MRI and bloods establishes the level.
When this is relevant
- Sudden unilateral weakness - stroke until proven otherwise; A&E, not private clinic.
- Progressive proximal weakness (difficulty rising from chairs, lifting arms) - suggests myopathy.
- Distal weakness with foot drop or hand weakness - suggests neuropathy or anterior horn cell disease.
- Fatigable weakness worse at the end of the day - suggests myasthenia.
- Bulbar features - dysarthria, dysphagia, tongue fasciculation - need urgent assessment for motor neurone disease.
How we investigate
Comprehensive neurological examination, nerve conduction studies and EMG via partner neurophysiology, MRI brain and spine where indicated, bloods (CK, ESR, CRP, thyroid, vitamin D, B12, autoimmune myositis panel, acetylcholine receptor antibodies).
Options at The Vesey
- Cause-directed treatment - immunosuppression for inflammatory myositis, pyridostigmine for myasthenia, B12 / vitamin D replacement where deficient.
- Strength rehabilitation with partner physiotherapy.
- Onward referral - tertiary neuromuscular centre for motor neurone disease, complex myopathies, neuromuscular junction disease.
- Acute pathway - any new unilateral weakness, particularly with facial droop, slurred speech or arm drift, is a stroke until proven otherwise. Call 999.
What is the difference between upper and lower motor neurone weakness? +
Upper motor neurone (UMN) weakness — from the brain or spinal cord — causes spasticity, brisk reflexes and an extensor plantar response. Lower motor neurone (LMN) weakness — from nerve roots, peripheral nerves or muscles — causes flaccidity, reduced or absent reflexes, and wasting. This distinction is made on examination and guides investigation.
What causes weakness on one side of the body? +
Unilateral weakness affecting the face, arm and leg typically indicates a lesion in the contralateral cerebral hemisphere — most commonly stroke, TIA, brain tumour or demyelination. New sudden hemiparesis is a stroke until proven otherwise: call 999 immediately. Subacute or progressive hemiparesis warrants urgent neurology assessment.
When is weakness a medical emergency? +
Call 999 for: sudden-onset weakness (especially unilateral), weakness with facial droop, speech difficulty or arm drift (FAST symptoms), weakness with neck stiffness and fever, rapidly ascending weakness over hours to days (possible Guillain-Barré), or weakness affecting breathing or swallowing.
What do nerve conduction studies involve? +
Nerve conduction studies (NCS) measure the speed and amplitude of electrical signals in peripheral nerves by applying small electrical pulses to the skin. EMG assesses muscle electrical activity via a fine needle electrode. The procedure takes 30–60 minutes and is mildly uncomfortable. Results help distinguish neuropathy, myopathy and neuromuscular junction disease.
Pricing at a glance
Initial neurology consultation £260. Nerve conduction studies via partner £390. MRI brain or spine £450. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book for unexplained progressive weakness lasting more than 2 weeks, fatigable weakness, or an existing diagnosis that needs a structured second opinion. Acute weakness = 999, not private clinic.
Cost and pathway
Initial neurology consultation £260. Nerve conduction studies via partner £390. MRI brain or spine £450.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our neurology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727