Neuromuscular   

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


N Engl J Med, 2022 Oct 06

Muscle & nerve, 2003-02

Muscle & nerve, 2012-06

Muscle Nerve, 2022 Nov 29

Muscle & nerve, 2019 Nov 06

Journal of clinical neuromuscular disease, 2021 Jun 01

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J Clin Rheumatol, 2021 Sep 23

The New England journal of medicine, 2015-10-22

Rheumatol Int, 2019 Feb 18

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Lancet Neurol, 2018 Mar 07

Pain medicine (Malden, Mass.), 2019-06-01

Continuum (Minneap Minn),

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,

Lancet Neurol, 2021 Mar 17

Ann Neurol,

Neurology, 2021 Oct 11

Current rheumatology reports, 2015-10

Curr Opin Rheumatol,

Neurology, 2020 Nov 03

Ann Rheum Dis, 2017 Dec

Rheumatology (Oxford, England), 2017-06-01

Autoimmun Rev, 2012 Jul 05

J Immunol Methods, 2016 Feb 18

Lancet Neurol, 2021 Jul

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

J Neurol Neurosurg Psychiatry, 2015 Jan 27

J Clin Neuromuscul Dis, 2018 Sep

Int J Mol Sci, 2022 May 24

N Engl J Med, 2020 Sep 3

Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases, 2010

BMC Res Notes, 2018 Mar 14

Ann Indian Acad Neurol, 2018 Jul-Sep

Neurol Int, 2014 Aug 08

Front Neurosci, 2023 Apr 24

Diabetes Care, 2002 Oct

Pediatr Blood Cancer, 2021 Oct

Brain, 2013 Oct 26

Clin Neurophysiol Pract, 2019 Jul 12

Muscle & nerve, 2016-04

Muscle & nerve, 2018-03-06

Cochrane Database Syst Rev, 2017 Jan 10

Amyotroph Lateral Scler, 2009 Aug

Neurology, 2019-01-22

Eur J Neurol, 2021 Nov 21

Muscle & nerve, 2009-08

J Neurol Sci, 2020 Jul 24

Neurotherapeutics, 2022 May 18

N Engl J Med, 2022 Sep 22

J. Neurol. Sci., 2008-12-15

J Clin Oncol, 2003 Jul 01

Int J Radiat Biol, 2018 Apr 27

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Turk Gogus Kalp Damar Cerrahisi Derg, 2018 Sep 16

The New England journal of medicine, 1993-12-30

Cureus, 2022 Oct 24

Journal of clinical apheresis, 2022 Feb 04

Cutis, 2023 Aug

Journal of translational internal medicine, 2019 Dec 31

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Journal of surgical orthopaedic advances, 2014

The Physician and sportsmedicine, 1992-11

The American journal of sports medicine, 2015 Sep 02

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Diabetes care, 2011-09

Nutrients, 2023 Aug 18

Endocrine reviews, 2019 Feb 01

European journal of neurology, 2011 Nov 25

Neurology, 2007 Apr 03

European journal of neurology, 2023 Oct 10

Journal of pain research, 2017 Jan 27

JAMA neurology, 2018-12-01

Journal of neuroimmunology, 2022 Apr 09

Neurology, 2011-03-22

Neurology(R) neuroimmunology & neuroinflammation, 2021 May 18

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

Immunol Invest, 1985 Jun

Lupus, 2024 Jan 16

Brain and behavior, 2023 Apr 19

Scientific reports, 2022 Feb 15

Clinical neurology and neurosurgery, 2020 Sep 28

JAMA neurology, 2015 Aug

Journal of epidemiology, 2015 May 02

Muscle & nerve, 2015-09

Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases, 2010-12

Journal of neurology, neurosurgery, and psychiatry, 2020 Jun 23

Journal of neurology, 2023 Jun 28

Annals of neurology, 2020 Jan 06

Molecular genetics and metabolism, 2022 Jul 26

Muscle & nerve, 2023 Nov 17

Seminars in neurology, 2008-04

Seminars in neurology, 2019 Oct 22