Questions discussed in this category

When do you use specialized panels for neuropathy? Which panels do you typically use?

Patients often see a dietician at ALS centers, but what do you discuss with patients before they have a formal consult with a dietician?

Particularly the increased risk for ALS in patients with DM in East Asian populations: Vasta et al., Neurological Sciences 2021.

For example, the patient may have other findings such as an elevated CRP. Would you diagnose SLE, or would you want to see other serologies or finding...

Will you still favor starting with steroids and traditional immunosuppressive agents, move IVIG earlier in your treatment strategy, or start with IVIG...

Is a biopsy or EMG helpful in confirming the etiology? What is the best treatment for sarcoid neuropathy?

These are new medications and, to my knowledge, there is no agreed-upon standardized approach as to when they should be used.

The patient returned with recurrent subjective sensory or motor deficits. The initial GQ1B was >1:6400. Two years later, GQ1B was 1:3200.

How would you treat a patient with necrotizing myopathy with positive anti-HMHCoR Ab (and low TIF1 gamma) that failed prednisone + Cellcept, IVIG + Ce...

Are there any environmental exposures you ask about for newly diagnosed ALS patients? 

B5 deficiency can be seen in patients with burning feet syndrome, do you typically screen for this when assessing for neuropathy?

How does this strategy change depending on the acuity or chronicity of the symptoms?

What do you recommend for surveillance and when to start the “three R’s” (riluzole, radicava/edaravone, and relyvrio (sodium PB/TUDC...

Do you switch MG patients from Soliris to Vyvgart due to cost, and with switching do you have a recommended wash out period? 

Is there any role for a surgical intervention in patients with distal weakness, who has marked peripheral neuropathy but also lumbosacral radiculopath...

What is the best way to treat late onset myasthenia gravis (in this case, age >90)? Would the newer complement inhibitors be safe? Steroids in this...

How do you account for a normal EMG/NCS in the setting of prolonged clinical symptoms suggestive of a radiculopathy? How do you explain this to patien...

In patients with hx of metastatic cancer, presenting with unilateral proximal arm weakness. No checkpoint inhibitors use.   Which CSF lab...

When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?

Assouline et al., PMID 24411632 recommend delivering 500cGy x 4 fractions = 2000cGy on days 1, 3, 8, 10. Do you follow this schedule, treat every othe...

In patients with suspected CIDP, does the use of imaging—MRI (thickening or abnormal enhancement of cervical/lumbar nerve roots or brachial/lumb...

Is there a role for using a trial of pyridostigmine as a diagnostic aid in a patient with suspected (but not confirmed) myasthenia gravis?

In patients presenting with likely statin-induced myopathy versus statin-induced autoimmune necrotizing myopathy - how do you approach the decision re...

How do you counsel young adults with antibody-negative necrotizing myopathy on prognosis, risk of recurrence, and long-term monitoring/treatment?

For patients who present with elevated myoglobin in the setting of normal creatinine kinase and exercise intolerance, what work up process do you typi...

How do you decide if and when to send patients with AChR+ ocular myasthenia gravis for thymectomy?

I teach my students/residents that they should hardly ever get routine X-rays in patients presenting with radicular symptoms. MRI far better for seein...

How long do you wait (from onset of symptoms) to do a EMG/NCS in a patient with GBS?

Is there is a particular pattern of extraocular motility restriction in Miller Fisher syndrome? 

Given the slow recovery of nerve damage, what would you expect to see on a repeat EMG after treatment? Continued denervation or just sequelae of past ...

Papers discussed in this category

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Muscle & nerve, 2012-06

Muscle Nerve, 2022 Nov 29

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Brain : a journal of neurology, 2016-05

Scand J Rheumatol, 2018 May 18

Clin Neurophysiol Pract, 2018 Apr 05

Muscle Nerve, 2021 May 04

Journal of clinical neuromuscular disease, 2010-12


Lancet Neurol, 2021 Mar 17

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Neurology, 2021 Oct 11

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Neurology, 2020 Nov 03

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J Immunol Methods, 2016 Feb 18

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Muscle & nerve, 2010-08

The Laryngoscope, 2016-01

Journal of the neurological sciences, 2011-09-15

J Peripher Nerv Syst, 2021 Jul 30

Neurology, 2020 Jan 20

Eur J Neurol, 2019 Aug 12

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J Clin Neuromuscul Dis, 2018 Sep

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Pediatr Blood Cancer, 2021 Oct

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Clin Neurophysiol Pract, 2019 Jul 12

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Neurology, 2019-01-22

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Neurology, 2007 Apr 03

European journal of neurology, 2023 Oct 10

Journal of pain research, 2017 Jan 27

JAMA neurology, 2018-12-01

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Neurology, 2011-03-22

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The New England journal of medicine, 2003-10-16

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