Demyelinating disorders (Guillain-Barré, chronic inflammatory demyelinating polyneuropathy [CIDP]).
Myasthenia gravis.
Infectious (poliomyelitis, diphtheria).
Toxic (botulism, tick paralysis, paralytic shellfish toxin, puffer fish, newts).
Metabolic (acquired or familial hypokalemia, hypophosphatemia, hypermagnesemia).
Metal poisoning (arsenic, thallium).
Porphyria
- Depression.
- Malingering. Anemia.
- Hypothyroidism.
- Medications (e.g., sedatives, antidepressants, narcotics).
- CHF.
- Renal failure.
- Liver failure.
- Respiratory insufficiency.
- Alcoholism.
- Nutritional deficiencies.
- Disorders of motor unit.
- Basal ganglia disorders.
- Upper motor neuron lesions.
- Anxiety disorder.
- Infectious process.
- Anemia.
- Renal insufficiency.
- Hyperventilation.
- Malignancy.
- Hypothyroidism.
- Hypotension.
- Hypercapnia.
- Hypoglycemia.
- Cardiac arrhythmias.
- Hepatic insufficiency.
- Electrolyte imbalance.
- Malnutrition.
- Cerebrovascular insufficiency.
- Sedentary lifestyle.
- Fluid overload.
- Discontinuation of tobacco abuse.
- Endocrine disorders (hypothyroidism, hyperinsulinism associated with maturity-onset DM, Cushing’s syndrome, hypogonadism, insulinoma, hyperprolactinemia, acromegaly).
- Medications (nutritional supplements, oral contraceptives, glucocorticoids, etc.).
- Anxiety disorders with compulsive eating.
- Laurence-Moon-Biedl syndrome, Prader-Willi syndrome, other congenital diseases.
- Hypothalamic injury (rare; <100 cases reported in medical literature).
- Malignancy.
- Psychiatric disorders (depression, anorexia nervosa).
- New-onset DM.
- Malabsorption.
- COPD.
- AIDS.
- Uremia, liver disease.
- Thyrotoxicosis, pheochromocytoma, carcinoid syndrome.
- Addison’s disease. Intestinal parasites. Peptic ulcer disease.
- Inflammatory bowel disease.
- Food faddism.
- Postgastrectomy syndrome
- Asthma.
- COPD.
- Interstitial lung disease.
- Infections (pneumonia, bronchitis, bronchiolitis, epiglottitis).
- Cardiac asthma.
- GERD with aspiration.
- Foreign body aspiration.
- Pulmonary embolism.
- Anaphylaxis.
- Obstruction of airway (neoplasm, goiter, edema or hemorrhage from trauma, aneurysm, congenital abnormalities, strictures, spasm).
- Carcinoid syndrome
Reactive airways disease.
Atopic asthma.
Infection-associated airway reactivity.
Exercise-induced asthma.
Salicylate-induced asthma and nasal polyposis.
Asthmatic bronchitis.
Other hypersensitivity reactions:
- Hypersensitivity pneumonitis.
- Tropical eosinophilia.
- Visceral larva migrans.
- Allergic bronchopulmonary aspergillosis.
Aspiration:
- Foreign body.
- Food, saliva, gastric contents.
- Laryngotracheoesophageal cleft.
- Tracheoesophageal fistula, H-type.
- Pharyngeal incoordination or neuromuscular weakness.
Cystic fibrosis.
Primary ciliary dyskinesia. Cardiac failure.
Bronchiolitis obliterans.
Extrinsic compression of airways:
- Vascular ring.
- Enlarged lymph node.
- Mediastinal tumor.
- Lung cysts.
Tracheobronchomalacia.
Endobronchial masses.
Gastroesophageal reflux.
Pulmonary hemosiderosis.
Sequelae of bronchopulmonary dysplasia.
“Hysterical” glottic closure.
Cigarette smoke, other environmental insults
Childhood (2-10 yr)
Intraarticular
- Infection.
Periarticular
- Fracture.
- Osteomyelitis.
Adolescence (10-18 yr)
Intraarticular
- Infection.
Periarticular
- Trauma.
- Osteomyelitis.
- Tumors.
- Ganglion.
- Idiopathic wrist pain.
Early Adulthood (18-30 yr)
Intraarticular
- Inflammatory arthritis.
- Infection.
- Osteoarthritis.
Periarticular
- Peripheral nerve entrapment.
- Tendonitis.
Referred
- Cervical.
Adulthood (30-50 yr)
Intraarticular
- Inflammatory arthritis.
- Infection.
- Osteoarthritis.
Periarticular
- Peripheral nerve entrapment.
- Tendonitis.
Referred
- Cervical.
- Chest.
- Cardiac.
Old age (>50 yr)
Intraarticular
- Inflammatory arthritis.
- Osteoarthritis.
Periarticular
- Peripheral nerve entrapment.
- Tendonitis.
Referred
- Cervical.
- Chest.
- Cardiac.
MECHANICAL
- Osteoarthritis.
- Ligament tear.
- Fracture
- Ganglion.
- De Quervain’s tenosynovitis.
- Avascular necrosis (scaphoid, lunate).
- Nonunion of scaphoid or lunate.
- Neoplasm.
METABOLIC
- Pregnancy.
- Diabetes.
- Gout.
- Pseudogout.
- Paget’s disease.
- Acromegaly.
- Hypothyroidism.
- Hyperparathyroidism.
INFECTIOUS
- Osteomyelitis.
- Septic arthritis.
- Cat-scratch disease.
- Tick bite (Lyme disease, babesiosis).
- Tuberculosis.
NEUROLOGIC
- Peripheral neuropathy.
- Nerve injury (median, ulnar, radial nerve).
- Thoracic outlet compression syndrome.
- Distal posterior interosseous nerve syndrome.
RHEUMATOLOGIC
- Psoriasis.
- RA.
- SLE, mixed connective tissue disorder (MCTD).
- Scleroderma.
MISCELLANEOUS
- Granulomatous (sarcoidosis).
- Amyloidosis.
- Multiple myeloma.
- Leukemia.
MEDICATIONS
- Tricyclic antidepressants: amitriptyline (Elavil), doxepin (Sinequan).
- Antihistamines: diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), promethazine (Phenergan), and many cold and decongestant preparations.
- Anticholinergic agents: antiemetics such as scopolamine, antispasmodic agents such as oxybutynin chloride (Ditropan).
ABNORMALITIES OF EYELID FUNCTION
- Neuromuscular disorders.
- Aging.
- Thyrotoxicosis.
ABNORMALITIES OF TEAR PRODUCTION
- Hypovitaminosis A.
- Stevens-Johnson syndrome.
- Familial diseases affecting sebaceous secretions.
ABNORMALITIES OF CORNEAL SURFACES
- Scarring from past injuries and herpes simplex infection.
MEDICATIONS
- Tricyclic antidepressants: amitriptyline (Elavil), doxepin (Sinequan).
- Antihistamines: diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), promethazine (Phenergan), and many cold and decongestant preparations.
- Anticholinergic agents: antiemetics such as scopolamine, antispasmodic agents such as oxybutynin chloride (Ditropan).
DEHYDRATION
- Debility.
- Fever.
POLYURIA
- Alcohol intake.
- Arrhythmia.
- Diabetes.
PREVIOUS HEAD AND NECK IRRADIATION SYSTEMIC DISEASES
- Sjögren’s syndrome.
- Sarcoidosis.
- Amyloidosis.
- Human immunodeficiency virus (HIV) infection.
- Graft-versus-host disease
- Normal coloration.
- Concentrated urine.
- Use of multivitamin supplements.
- Diet rich in carrots.
- Use of Cascara.
- Urinary tract infection