Muscle diseases
This chapter is concerned with those disorders in which the primary pathological process affects skeletal muscle, for which in everyday clinical practice the term myopathy is convenient shorthand. However, it must be stressed that diseases of the motor nerves and neuromuscular junction can produce an identical clinical picture to several of the myopathies, and this will be emphasized many times throughout the chapter when considering differential diagnosis. Indeed sometimes, despite one’s best efforts, one is left uncertain as to whether the primary disease process is in the nerves or muscles—it may be that in some conditions the disease process directly affects both nerves and muscles. The intimate relationship, both structural and functional, between nerves and the muscles they innervate means that disease of one may have a profound effect on the other—the most striking example is the change that occurs to skeletal muscle fibre-type distribution in denervation.