Additional Information
Book Details
Abstract
In this unique book, Dr. Bertorini guides you through more than 100 cases that demonstrate the diagnosis and management of a wide range of common and rare neuromuscular disorders. No other reference boasts such a large array of clinical studies devoted to all areas of this broad topic! Each case study reviews the etiologies, pathogenesis, differential diagnosis, and management of a particular disorder, helping you not only recognize its presentation, but also determine a diagnosis and the best treatment plans for your patients. You’ll also find expert guidance on the basic mechanisms of neuromuscular disorders, clinical examination, and diagnostic tests—including EMG, muscle biopsy, genetic testing, and more.
- More than 100 detailed case studies explore both common and rare neuromuscular disorders and the treatment protocols for each, equipping you with the knowledge you need to confidently manage any challenge. Each case includes a summary of important points or highlights of the study.
- Case studies are arranged either by complaint or by diagnosis so that you can successfully manage your patients with or without an initial diagnosis.
- Comprehensive coverage of EMGs and nerve conduction studies and other diagnostic tests, including muscle and nerve biopsies and genetic testing, helps you accurately diagnose nerve, muscle, and neuromuscular transmission disorders.
- Detailed discussions of treatment plans and commonly used drugs enhance your management of autoimmune disorders, painful neuropathy, dysautonomia, and other neuromuscular disorders.
- A reader-friendly format takes you step by step through the diagnosis and treatment of neuromuscular disorders, from the basic anatomy and physiology of the nerve and muscle through to clinical evaluation, diagnostic testing, and therapy.
- More than 350 high-quality illustrations, including full-color patient photographs, biopsies, and EMG tracings, make complex concepts easier to understand and apply.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Neuromuscular Case Studies | iii | ||
| Copyright Page | iv | ||
| Contents | xi | ||
| Preface | vii | ||
| Acknowledgments | ix | ||
| Chapter 1. Neuromuscular Anatomy and Function | 1 | ||
| ANATOMY OF THE CRANIAL AND PERIPHERAL NERVES | 3 | ||
| THE BRACHIAL PLEXUS | 4 | ||
| THE LUMBOSACRAL PLEXUS | 8 | ||
| STRUCTURE OF THE PERIPHERAL NERVES | 13 | ||
| THE STRUCTURE OF MUSCLES | 14 | ||
| THE NEUROMUSCULAR JUNCTION | 17 | ||
| PHYSIOLOGY | 18 | ||
| REFERENCES | 25 | ||
| Chapter 2. Neurologic Evaluation and Ancillary Tests | 27 | ||
| THE HISTORY AND PHYSICAL EXAMINATION | 27 | ||
| IMPORTANT ANCILLARY TESTS | 29 | ||
| CLINICAL ELECTROPHYSIOLOGIC STUDIES | 31 | ||
| AUTONOMIC TESTING | 55 | ||
| MUSCLE/NERVE HISTOPATHOLOGY | 57 | ||
| REFERENCES | 73 | ||
| Chapter 3. Therapy in Neuromuscular Diseases | 77 | ||
| TREATMENT OF PAINFUL NEUROPATHIES | 77 | ||
| DRUGS USED TO TREAT CHRONIC PAIN | 78 | ||
| TREATMENT OF AUTONOMIC DYSFUNCTION | 80 | ||
| OTHER SYMPTOMATIC TREATMENT IN NEUROMUSCULAR DISORDERS | 81 | ||
| TREATMENT OF MYASTHENIA GRAVIS AND OTHER DISORDERS OF NEUROMUSCULAR TRANSMISSION | 82 | ||
| IMMUNOTHERAPY | 82 | ||
| OTHERS | 89 | ||
| REFERENCES | 89 | ||
| Case Studies | 93 | ||
| Case 1 An Elderly Woman with Numbness in the Hands | 95 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 95 | ||
| WHAT WERE THE EMG FINDINGS? | 96 | ||
| SUMMARY | 97 | ||
| Case 2 A Diabetic Man with Arm Swelling, Pain, and Numbness | 98 | ||
| WHAT WERE THE EMG FINDINGS? | 99 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 99 | ||
| FOLLOW-UP | 100 | ||
| A SECOND EMG TEST WAS PERFORMED | 100 | ||
| WHAT DID THE SECOND EMG SHOW? | 101 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 101 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 101 | ||
| SUMMARY | 101 | ||
| DISCUSSION (CASES 1 AND 2) | 101 | ||
| IMPORTANT POINTS | 103 | ||
| REFERENCES | 103 | ||
| Case 3 A Diabetic Man with Hand Numbness and Fainting Spells | 106 | ||
| WHAT WERE THE EMG FINDINGS? | 107 | ||
| WHAT SHOULD BE DONE NEXT? | 107 | ||
| WHAT SHOULD BE THE MANAGEMENT? | 108 | ||
| SUMMARY | 108 | ||
| DISCUSSION | 108 | ||
| IMPORTANT POINTS | 109 | ||
| REFERENCES | 109 | ||
| Case 4 A Man with Hand Pain | 111 | ||
| WHAT WERE THE EMG FINDINGS? | 112 | ||
| HOW DOES ONE PROVE THE DIAGNOSIS OF A MARTIN-GRUBER ANASTOMOSIS? | 113 | ||
| WHAT IS THE MARTIN-GRUBER ANASTOMOSIS? | 113 | ||
| SUMMARY | 114 | ||
| IMPORTANT POINTS | 115 | ||
| REFERENCES | 115 | ||
| Case 5 A Woman with Hand Weakness, Numbness, and Pain After Cardiac Catheterization | 116 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 116 | ||
| WHAT WERE THE EMG FINDINGS? | 118 | ||
| WHAT SHOULD BE DONE NEXT? | 118 | ||
| SUMMARY | 118 | ||
| Case 6 A Man Who Practices Karate and Has Forearm Pain | 119 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 119 | ||
| WHAT WERE THE EMG FINDINGS? | 120 | ||
| SUMMARY | 120 | ||
| DISCUSSION | 120 | ||
| IMPORTANT POINTS | 121 | ||
| REFERENCES | 122 | ||
| Case 7 A Man with a History of Polio Who Developed Hand Weakness and Numbness | 123 | ||
| WHAT IS THE CLINICAL DIAGNOSIS? | 123 | ||
| WHAT WERE THE EMG FINDINGS? | 125 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 125 | ||
| WHAT WAS THE MANAGEMENT? | 125 | ||
| DISCUSSION | 125 | ||
| WHAT SHOULD BE THE TREATMENT? | 126 | ||
| IMPORTANT POINTS | 127 | ||
| REFERENCES | 128 | ||
| Case 8 A Young Woman with Multiple Sclerosis and Hand Numbness | 129 | ||
| WHAT ARE THE MOST LIKELY POSSIBILITIES? | 129 | ||
| WHAT WERE THE EMG FINDINGS? | 130 | ||
| WHAT WOULD BE THE NEXT TEST? | 131 | ||
| WHAT WOULD BE THE MANAGEMENT? | 131 | ||
| DISCUSSION | 131 | ||
| SUMMARY | 133 | ||
| IMPORTANT POINTS | 133 | ||
| REFERENCES | 133 | ||
| Case 9 A Woman with a Wrist Drop and a Mass in the Arm | 134 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 134 | ||
| WHAT WERE THE EMG FINDINGS? | 135 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 135 | ||
| WHAT ARE THE DIAGNOSES AND TREATMENT? | 136 | ||
| DISCUSSION | 136 | ||
| SUMMARY | 138 | ||
| IMPORTANT POINTS | 138 | ||
| REFERENCES | 138 | ||
| Case 10 A Man with Bilateral Arm Weakness After Lumbar Surgery | 139 | ||
| WHAT WERE THE EMG FINDINGS? | 141 | ||
| WHAT SHOULD BE DONE NEXT? | 141 | ||
| DISCUSSION | 141 | ||
| SUMMARY | 143 | ||
| IMPORTANT POINTS | 143 | ||
| REFERENCES | 143 | ||
| Case 11 A Woman with Acute Onset of Shoulder Pain and Weakness | 144 | ||
| WHAT IS THE CLINICAL DIAGNOSIS? | 144 | ||
| WHAT WERE THE EMG FINDINGS? | 146 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 146 | ||
| TREATMENT | 146 | ||
| DISCUSSION | 146 | ||
| SUMMARY | 147 | ||
| IMPORTANT POINTS | 147 | ||
| REFERENCES | 147 | ||
| Case 12 A Man with Lymphoma and Numbness in the Fingers of One Hand | 149 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 149 | ||
| DISCUSSION | 151 | ||
| SUMMARY | 151 | ||
| IMPORTANT POINTS | 151 | ||
| REFERENCES | 152 | ||
| Case 13 A Woman with Arm Weakness After Treatment for Breast Cancer | 153 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 153 | ||
| WHAT DID THE EMG SHOW? | 154 | ||
| DISCUSSION | 155 | ||
| SUMMARY | 155 | ||
| IMPORTANT POINTS | 155 | ||
| REFERENCES | 155 | ||
| Case 14 A Diabetic Man with Shoulder Pain and Weakness | 156 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 156 | ||
| WHAT WERE THE EMG FINDINGS? | 157 | ||
| WHAT OTHER TESTS SHOULD BE ORDERED? | 157 | ||
| WHAT IS THE TREATMENT? | 157 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 158 | ||
| DISCUSSION | 158 | ||
| SUMMARY | 158 | ||
| IMPORTANT POINTS | 158 | ||
| REFERENCES | 159 | ||
| Case 15 A Woman with Arm Weakness and a Skin Rash | 160 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 160 | ||
| WHAT WERE THE EMG FINDINGS? | 161 | ||
| WHAT SHOULD BE DONE NEXT? | 161 | ||
| DISCUSSION | 161 | ||
| SUMMARY | 162 | ||
| IMPORTANT POINTS | 162 | ||
| REFERENCES | 162 | ||
| Case 16 A Woman with Neck and Arm Pain | 163 | ||
| WHAT WERE THE EMG FINDINGS? | 164 | ||
| SUMMARY | 164 | ||
| Case 17 A Woman with Neck Pain and a Weak Arm | 165 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 165 | ||
| WHAT NERVE CONDUCTION TESTS SHOULD BE DONE AND WHAT MUSCLES STUDIED ON EMG? | 166 | ||
| SUMMARY | 166 | ||
| DISCUSSION (CASES 16 AND 17) | 166 | ||
| IMPORTANT POINTS | 167 | ||
| REFERENCES | 168 | ||
| Case 18 A Woman with Back Pain and Leg Weakness | 170 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 170 | ||
| WHAT SHOULD BE THE DIAGNOSTIC WORKUP? | 170 | ||
| WHAT WERE THE EMG FINDINGS? | 172 | ||
| SUMMARY | 172 | ||
| IMPORTANT POINTS | 172 | ||
| Case 19 A Woman with Back Pain and Weakness | 175 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 175 | ||
| WHAT TESTS SHOULD BE DONE? | 175 | ||
| AN EMG TEST WAS PERFORMED | 175 | ||
| WHAT WERE THE EMG FINDINGS? | 176 | ||
| SUMMARY | 176 | ||
| IMPORTANT POINTS | 176 | ||
| Case 20 A Woman with Back Pain and Unusual Nerve Conduction Tests | 177 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS IN THIS CASE? | 177 | ||
| WHAT WOULD BE THE MOST APPROPRIATE DIAGNOSTIC TEST? | 177 | ||
| WHAT WERE THE NERVE CONDUCTION TEST FINDINGS? | 178 | ||
| WHAT IS THE SIGNIFICANCE OF THE FINDINGS OF THIS TEST AND WHAT SHOULD BE DONE NEXT? | 178 | ||
| WHAT WERE THE EMG FINDINGS? | 179 | ||
| WHAT SHOULD BE THE NEXT TEST FOR THIS PATIENT? | 179 | ||
| SUMMARY | 180 | ||
| IMPORTANT POINTS | 180 | ||
| DISCUSSION (CASES 18, 19, AND 20) | 180 | ||
| REFERENCES | 181 | ||
| Case 21 A Man with Pheochromocytoma and Back Pain | 183 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 183 | ||
| WHAT WERE THE EMG FINDINGS? | 184 | ||
| DISCUSSION | 184 | ||
| SUMMARY | 184 | ||
| IMPORTANT POINTS | 184 | ||
| REFERENCES | 185 | ||
| Case 22 A Diabetic Man with Back and Leg Pain | 187 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 187 | ||
| WHAT DIAGNOSTIC TESTS SHOULD BE DONE? | 187 | ||
| WHAT WERE THE EMG FINDINGS? | 188 | ||
| WHAT WOULD BE THE NEXT TEST? | 188 | ||
| WHAT WOULD ONE DO NEXT? | 189 | ||
| DISCUSSION | 189 | ||
| SUMMARY | 189 | ||
| IMPORTANT POINTS | 190 | ||
| REFERENCES | 190 | ||
| Case 23 A Man with Leg Pain While Walking | 191 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 191 | ||
| WHAT SHOULD BE DONE? | 191 | ||
| WHAT WERE THE EMG FINDINGS? | 192 | ||
| WHAT SHOULD BE DONE NEXT? | 193 | ||
| WHAT SHOULD BE THE TREATMENT? | 193 | ||
| DISCUSSION | 194 | ||
| SUMMARY | 194 | ||
| IMPORTANT POINTS | 194 | ||
| REFERENCES | 194 | ||
| Case 24 A Man with Foot Pain | 196 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 196 | ||
| WHAT IS A TARSAL TUNNEL SYNDROME? | 196 | ||
| WHAT WERE THE EMG FINDINGS? | 197 | ||
| WHAT ARE THE EMG FINDINGS OF TARSAL TUNNEL SYNDROME? | 197 | ||
| WHAT SHOULD BE THE NEXT DIAGNOSTIC TEST IN THIS PATIENT? | 197 | ||
| DISCUSSION | 199 | ||
| SUMMARY | 200 | ||
| IMPORTANT POINTS | 200 | ||
| REFERENCES | 200 | ||
| Case 25 A Man with Unilateral Proximal Leg Weakness After Heart Catheterization | 201 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 201 | ||
| WHAT TESTS SHOULD BE DONE? | 201 | ||
| WHAT WERE THE EMG FINDINGS? | 202 | ||
| DISCUSSION | 203 | ||
| SUMMARY | 204 | ||
| IMPORTANT POINTS | 204 | ||
| REFERENCES | 204 | ||
| Case 26 A Woman with Uterine Cancer and Unilateral Leg Weakness | 205 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 205 | ||
| WHAT WERE THE EMG FINDINGS? | 206 | ||
| WHAT SHOULD ONE DO NEXT? | 207 | ||
| DISCUSSION | 207 | ||
| SUMMARY | 208 | ||
| IMPORTANT POINTS | 208 | ||
| REFERENCES | 208 | ||
| Case 27 A Man with Burning Sensations in the Thigh | 210 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 210 | ||
| WHAT TESTS SHOULD BE ORDERED? | 210 | ||
| WHAT WERE THE EMG FINDINGS? | 211 | ||
| DISCUSSION | 211 | ||
| SUMMARY | 212 | ||
| IMPORTANT POINTS | 212 | ||
| REFERENCES | 212 | ||
| Case 28 A Man with Weakness and Fasciculations in the Lower Extremities | 214 | ||
| WHAT WERE THE EMG FINDINGS? | 215 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 215 | ||
| WHAT WILL BE THE NEXT DIAGNOSTIC TEST? | 215 | ||
| DISCUSSION | 215 | ||
| SUMMARY | 216 | ||
| IMPORTANT POINTS | 216 | ||
| REFERENCES | 217 | ||
| Case 29 A Woman with Unilateral Facial Weakness | 218 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 218 | ||
| WHAT TESTS NEED TO BE DONE? | 218 | ||
| WHAT WERE THE EMG FINDINGS? | 219 | ||
| DISCUSSION | 219 | ||
| SUMMARY | 220 | ||
| IMPORTANT POINTS | 220 | ||
| REFERENCES | 221 | ||
| Case 30 A Diabetic Woman with Muscle Weakness and Ophthalmoplegia | 222 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 222 | ||
| WHAT WERE THE EMG FINDINGS? | 224 | ||
| Case 31 A Man with a Dropped Head | 227 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 227 | ||
| WHAT WERE THE EMG FINDINGS? | 228 | ||
| DISCUSSION | 230 | ||
| SUMMARY | 232 | ||
| IMPORTANT POINTS | 232 | ||
| REFERENCES | 232 | ||
| Case 32. A Man in the “Barrel” | 234 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 234 | ||
| WHAT WERE THE EMG FINDINGS? | 235 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 236 | ||
| WHAT IS “MAN IN THE BARREL” SYNDROME? | 236 | ||
| WHAT IS THE TREATMENT OF BRACHIAL AMYOTROPHIC DIPLEGIA? | 237 | ||
| SUMMARY | 237 | ||
| IMPORTANT POINTS | 237 | ||
| REFERENCES | 237 | ||
| Case 33 A Man with a Long History of Muscle Weakness in One Arm | 239 | ||
| WHAT ARE THE DIFFERENTIAL DIAGNOSES? | 239 | ||
| WHAT WERE THE EMG FINDINGS? | 240 | ||
| BASED ON THIS, WHAT OTHER TESTS SHOULD BE DONE? | 240 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 242 | ||
| DISCUSSION | 242 | ||
| SUMMARY | 243 | ||
| IMPORTANT POINTS | 243 | ||
| REFERENCES | 243 | ||
| Case 34 A Man with Progressive Leg Muscle Weakness 20 Years After an Acute Paralysis | 245 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS AND WHAT TESTS NEED TO BE DONE? | 245 | ||
| WHAT WERE THE EMG FINDINGS? | 247 | ||
| WHAT WOULD YOU DO NEXT? | 247 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 247 | ||
| DISCUSSION | 247 | ||
| SUMMARY | 248 | ||
| IMPORTANT POINTS | 248 | ||
| REFERENCES | 248 | ||
| Case 35 A Man with One Large Calf | 249 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 249 | ||
| WHAT WERE THE EMG FINDINGS? | 250 | ||
| WHAT WOULD BE THE NEXT TESTS? | 251 | ||
| DISCUSSION | 251 | ||
| SUMMARY | 252 | ||
| IMPORTANT POINTS | 252 | ||
| REFERENCES | 253 | ||
| Case 36 A Man with Muscle Spasms and Elevated Serum Creatine Kinase | 255 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 255 | ||
| WHAT WERE THE EMG FINDINGS? | 257 | ||
| WHAT OTHER TESTS COULD BE USEFUL? | 258 | ||
| WHAT SHOULD BE DONE NEXT? | 258 | ||
| WHAT IS KENNEDY’S DISEASE? | 258 | ||
| SUMMARY | 259 | ||
| IMPORTANT POINTS | 259 | ||
| REFERENCES | 259 | ||
| Case 37 A Man with Muscle Twitching and Poor Balance | 261 | ||
| WHAT WERE THE EMG FINDINGS? | 262 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 262 | ||
| WHAT TESTS SHOULD BE DONE? | 263 | ||
| DISCUSSION | 263 | ||
| SUMMARY | 266 | ||
| IMPORTANT POINTS | 266 | ||
| REFERENCES | 266 | ||
| Case 38 A Floppy Child | 268 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 268 | ||
| WHAT SHOULD BE THE NEXT TEST? | 268 | ||
| WHAT WERE THE EMG FINDINGS? | 269 | ||
| WHAT IS THE NEXT TEST? | 269 | ||
| DISCUSSION | 269 | ||
| SUMMARY | 273 | ||
| IMPORTANT POINTS | 273 | ||
| REFERENCES | 274 | ||
| Case 39 A Man with Acute Areflexic Paralysis and Central Nervous System Symptoms | 275 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 275 | ||
| WHAT WERE THE EMG FINDINGS? | 276 | ||
| WHAT ADDITIONAL TESTS SHOULD BE DONE? | 277 | ||
| WHAT OTHER TESTS ARE IMPORTANT? | 277 | ||
| DISCUSSION | 278 | ||
| SUMMARY | 279 | ||
| IMPORTANT POINTS | 279 | ||
| REFERENCES | 279 | ||
| Case 40 A Man with Acute Muscle Weakness and Respiratory Failure | 281 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 281 | ||
| WHAT TESTS SHOULD BE DONE? | 281 | ||
| WHAT WERE THE EMG FINDINGS? | 282 | ||
| DISCUSSION | 284 | ||
| SUMMARY | 285 | ||
| IMPORTANT POINTS | 285 | ||
| REFERENCES | 285 | ||
| Case 41 A Young Woman with Acute Onset of Clumsiness and Ophthalmoplegia | 286 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 286 | ||
| WHAT TESTS SHOULD BE DONE? | 286 | ||
| WHAT WERE THE EMG FINDINGS? | 287 | ||
| WHAT OTHER TESTS WOULD BE DONE? | 287 | ||
| DISCUSSION | 288 | ||
| SUMMARY | 289 | ||
| IMPORTANT POINTS | 289 | ||
| REFERENCES | 289 | ||
| Case 42 A Woman with Seafood Poisoning in Catfish Country | 290 | ||
| WHAT WERE THE EMG FINDINGS? | 291 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 291 | ||
| WHAT IS CIGUATERA POISONING? | 291 | ||
| WHAT ARE OTHER INGESTIBLE SEAFOOD TOXINS? | 292 | ||
| SOME HISTORICAL ASPECTS OF SEAFOOD POISONING | 292 | ||
| SUMMARY | 293 | ||
| IMPORTANT POINTS | 293 | ||
| REFERENCES | 293 | ||
| Case 43 A Woman with a Kingly Disease | 294 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 294 | ||
| WHAT TESTS SHOULD BE DONE? | 294 | ||
| WHAT WERE THE EMG FINDINGS? | 297 | ||
| WHAT WOULD BE DONE NEXT? | 297 | ||
| BASED ON THE FINDINGS, WHAT IS THE MOST LIKELY DIAGNOSIS? | 298 | ||
| DISCUSSION | 298 | ||
| WHAT IS THE TREATMENT OF PORPHYRIA? | 300 | ||
| SUMMARY | 300 | ||
| IMPORTANT POINTS | 300 | ||
| REFERENCES | 301 | ||
| Case 44 A Myasthenic Woman with Persistent Weakness | 302 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 302 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 302 | ||
| WHAT WERE THE EMG FINDINGS? | 304 | ||
| WHAT SHOULD BE DONE? | 304 | ||
| DISCUSSION | 304 | ||
| SUMMARY | 306 | ||
| IMPORTANT POINTS | 306 | ||
| REFERENCES | 307 | ||
| Case 45 A Man with Neck Pain and Numbness in the Hands | 308 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 308 | ||
| WHAT TESTS WERE DONE? | 308 | ||
| WHAT WERE THE EMG FINDINGS? | 309 | ||
| WHAT WOULD ONE DO NEXT? | 310 | ||
| SUMMARY | 310 | ||
| Case 46 A Woman with Peripheral Neuropathy and Frequent Falls | 311 | ||
| WHAT WERE THE EMG FINDINGS? | 312 | ||
| WHAT OTHER TEST SHOULD BE ORDERED? | 312 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 312 | ||
| WHAT WOULD YOU DO NEXT? | 313 | ||
| WHAT IS THE IMPORTANCE OF COBALAMIN DEFICIENCY? | 313 | ||
| WHAT IS THE SCHILLING TEST? | 314 | ||
| SUMMARY | 314 | ||
| DISCUSSION (CASES 45 AND 46) | 314 | ||
| IMPORTANT POINTS | 315 | ||
| REFERENCES | 316 | ||
| Case 47 A Man with Weakness in the Legs | 317 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 317 | ||
| WHAT WERE THE EMG FINDINGS? | 318 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 318 | ||
| SUMMARY | 319 | ||
| Case 48 An Elderly Woman with Asymmetric Weakness and a Monoclonal Gammopathy | 320 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 320 | ||
| WHAT WERE THE EMG FINDINGS? | 321 | ||
| WHAT OTHER STUDIES NEED TO BE DONE? | 322 | ||
| SUMMARY | 322 | ||
| Case 49 A Man with Progressive Weakness and Fasciculations | 323 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 323 | ||
| WHAT WOULD ONE DO NEXT? | 323 | ||
| WHAT WERE THE EMG FINDINGS? | 325 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 326 | ||
| WHAT WOULD YOU DO NEXT? | 326 | ||
| SUMMARY | 326 | ||
| DISCUSSION (CASES 47, 48, AND 49) | 326 | ||
| IMPORTANT POINTS | 333 | ||
| REFERENCES | 334 | ||
| Case 50 A Man with Diabetic Polyneuropathy Who Developed Rapidly Progressive Weakness | 336 | ||
| WHAT TESTS WERE DONE? | 336 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 336 | ||
| WHAT WERE THE EMG FINDINGS? | 337 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 338 | ||
| WHAT SHOULD BE DONE NEXT? | 338 | ||
| WHAT IS THE BEST TREATMENT FOR THIS PATIENT? | 338 | ||
| DISCUSSION | 338 | ||
| SUMMARY | 340 | ||
| IMPORTANT POINTS | 340 | ||
| REFERENCES | 341 | ||
| Case 51 An Older Man with Leg Numbness | 342 | ||
| WHAT ARE THE MOST LIKELY DIAGNOSTIC POSSIBILITIES? | 342 | ||
| WHAT SHOULD THE WORKUP INCLUDE? | 342 | ||
| WHAT WERE THE EMG FINDINGS? | 343 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 343 | ||
| WHAT OTHER LABORATORY TESTS SHOULD BE DONE? | 344 | ||
| WHAT WERE THE RESULTS OF THE TESTS? | 344 | ||
| DISCUSSION | 344 | ||
| WHAT ARE MONOCLONAL GAMMOPATHIES? | 345 | ||
| WHAT OTHER CONDITIONS ARE ASSOCIATED WITH MONOCLONAL GAMMOPATHIES? | 346 | ||
| SUMMARY | 346 | ||
| IMPORTANT POINTS | 346 | ||
| REFERENCES | 346 | ||
| Case 52 A Woman with a Neuropathy and Symptoms of a Central Nervous System Disease | 348 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 348 | ||
| WHAT WERE THE EMG FINDINGS? | 349 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 349 | ||
| WHAT SHOULD BE DONE NEXT? | 350 | ||
| DISCUSSION | 350 | ||
| SUMMARY | 351 | ||
| IMPORTANT POINTS | 351 | ||
| REFERENCES | 351 | ||
| Case 53 A Man with Progressive Weakness After a Gastroplasty | 352 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 352 | ||
| WHAT WERE THE EMG FINDINGS? | 353 | ||
| WHAT SHOULD BE DONE NEXT? | 353 | ||
| WHAT SHOULD BE DONE NEXT? | 354 | ||
| DISCUSSION | 354 | ||
| SUMMARY | 355 | ||
| IMPORTANT POINTS | 355 | ||
| REFERENCES | 355 | ||
| Case 54 A Diabetic Woman with Proximal Leg Weakness and Pain | 357 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS FOR THIS PATIENT? | 357 | ||
| WHAT WILL BE THE NEXT DIAGNOSTIC TESTS? | 357 | ||
| WHAT WERE THE EMG FINDINGS? | 359 | ||
| WHAT WOULD ONE DO NEXT? | 359 | ||
| WHAT IS DIABETIC LUMBOSACRAL RADICULOPLEXUS NEUROPATHY? | 359 | ||
| WHAT IS THE TREATMENT OF DIABETIC RADICULOPLEXUS NEUROPATHY? | 359 | ||
| SUMMARY | 360 | ||
| IMPORTANT POINTS | 360 | ||
| REFERENCES | 360 | ||
| Case 55 A Diabetic Man with Bilateral Arm Weakness | 361 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 361 | ||
| WHAT NEEDS TO BE DONE? | 361 | ||
| WHAT WERE THE EMG FINDINGS? | 363 | ||
| DISCUSSION | 364 | ||
| SUMMARY | 364 | ||
| IMPORTANT POINTS | 364 | ||
| REFERENCES | 364 | ||
| Case 56 A Diabetic Man with Pain and Swelling in the Thigh | 365 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 365 | ||
| WHAT WOULD ONE DO NEXT? | 365 | ||
| DISCUSSION | 365 | ||
| SUMMARY | 366 | ||
| IMPORTANT POINTS | 366 | ||
| REFERENCES | 366 | ||
| Case 57 A Uremic Man with Burning Feet | 368 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 368 | ||
| WHAT TESTS SHOULD BE DONE? | 368 | ||
| WHAT WERE THE EMG FINDINGS? | 369 | ||
| DISCUSSION | 370 | ||
| SUMMARY | 371 | ||
| IMPORTANT POINTS | 371 | ||
| REFERENCES | 371 | ||
| Case 58A A Woman with Leg Numbness, Pain, Weakness, and Slow Nerve Conduction Velocities | 372 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 372 | ||
| WHAT WERE THE EMG FINDINGS? | 373 | ||
| WHAT SHOULD BE DONE NEXT? | 374 | ||
| SUMMARY | 374 | ||
| Case 58B A Boy with Leg Weakness | 375 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 375 | ||
| WHAT WERE THE EMG FINDINGS? | 376 | ||
| SUMMARY | 377 | ||
| DISCUSSION | 377 | ||
| IMPORTANT POINTS | 381 | ||
| REFERENCES | 381 | ||
| Case 59 A Man with Hand Weakness and Numbness After Skiing | 383 | ||
| WHAT WERE THE EMG FINDINGS? | 384 | ||
| WHAT IS THE LIKELY DIAGNOSIS? | 384 | ||
| WHAT WOULD BE THE NEXT TEST? | 385 | ||
| SUMMARY | 385 | ||
| Case 60 A Man with Recurrent Foot Drop | 386 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 386 | ||
| WHAT TESTS ARE INDICATED IN THIS CASE? | 386 | ||
| WHAT WERE THE EMG FINDINGS? | 389 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 389 | ||
| SUMMARY | 389 | ||
| DISCUSSION (CASES 59 AND 60) | 389 | ||
| IMPORTANT POINTS | 390 | ||
| REFERENCES | 391 | ||
| Case 61 An Elderly Woman with Foot Drop and Hand Weakness | 393 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 393 | ||
| WHAT WERE THE EMG FINDINGS? | 395 | ||
| THE FOLLOWING LABORATORY STUDIES WERE DONE | 395 | ||
| FOLLOW-UP | 395 | ||
| A SECOND EMG TEST WAS PERFORMED | 395 | ||
| WHAT WERE THE EMG FINDINGS? | 396 | ||
| WHAT DID THE NERVE AND MUSCLE BIOPSY SHOW? | 398 | ||
| SUMMARY | 398 | ||
| Case 62 A Woman with Rheumatoid Arthritis Who Developed Numbness and Pain in the Feet | 399 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 399 | ||
| WHAT WERE THE EMG FINDINGS? | 401 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 401 | ||
| WHAT SHOULD BE DONE NEXT? | 401 | ||
| SUMMARY | 401 | ||
| DISCUSSION (CASES 61 AND 62) | 401 | ||
| IMPORTANT POINTS | 403 | ||
| REFERENCES | 403 | ||
| Case 63 A Woman with Granulomatous Lesions in the Lungs and a Peripheral Neuropathy | 405 | ||
| WHAT WERE THE TEST FINDINGS? | 406 | ||
| WHAT TESTS SHOULD BE DONE NEXT? | 406 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 407 | ||
| WHAT IS WEGENER’S GRANULOMATOSIS? | 408 | ||
| WHAT IS ANCA? | 408 | ||
| WHAT IS THE PATHOGENESIS OF THE VASCULITIS IN WEGENER’S GRANULOMATOSIS? | 408 | ||
| WHAT IS THE TREATMENT OF WEGENER’S GRANULOMATOSIS? | 408 | ||
| SUMMARY | 409 | ||
| IMPORTANT POINTS | 409 | ||
| REFERENCES | 409 | ||
| Case 64 A Man with a Neuropathy, Weight Loss, and Lung Nodules | 411 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 411 | ||
| WHAT WERE THE EMG FINDINGS? | 412 | ||
| WHAT SHOULD BE DONE NEXT? | 412 | ||
| DISCUSSION | 412 | ||
| SUMMARY | 414 | ||
| IMPORTANT POINTS | 414 | ||
| REFERENCES | 414 | ||
| Case 65 A Woman with Difficulty Walking and Ataxia | 415 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 415 | ||
| WHAT WERE THE EMG FINDINGS? | 416 | ||
| ARE OTHER TESTS NEEDED? | 417 | ||
| DISCUSSION | 418 | ||
| SUMMARY | 420 | ||
| IMPORTANT POINTS | 421 | ||
| REFERENCES | 421 | ||
| Case 66 A Man with Progressive Neuropathy and Congestive Heart Failure | 422 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 422 | ||
| WHAT WERE THE EMG FINDINGS? | 424 | ||
| WHAT SHOULD BE THE NEXT DIAGNOSTIC TEST? | 424 | ||
| WHAT IS AMYLOIDOSIS? | 424 | ||
| WHAT ARE THE DIFFERENT TYPES OF AMYLOIDOSIS AFFECTING PERIPHERAL NERVES? | 425 | ||
| SUMMARY | 427 | ||
| IMPORTANT POINTS | 427 | ||
| REFERENCES | 427 | ||
| Case 67 An Elderly Woman with a Progressive Neuropathy | 429 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 429 | ||
| WHAT SHOULD BE DONE? | 429 | ||
| WHAT WERE THE EMG FINDINGS? | 430 | ||
| DISCUSSION | 430 | ||
| SUMMARY | 431 | ||
| IMPORTANT POINTS | 431 | ||
| REFERENCES | 431 | ||
| Case 68 A Young Woman with Difficulty Swallowing | 433 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 433 | ||
| WHAT TESTS SHOULD BE DONE? | 433 | ||
| WHAT WERE THE EMG FINDINGS? | 434 | ||
| SUMMARY | 435 | ||
| Case 69 A Young Woman with Intermittent Weakness and a Positive Family History of Similar Problems | 436 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 436 | ||
| WHAT WERE THE EMG FINDINGS? | 437 | ||
| WHAT SHOULD YOU DO NEXT? | 437 | ||
| FOLLOW-UP | 438 | ||
| SUMMARY | 438 | ||
| DISCUSSION (CASES 68 AND 69) | 438 | ||
| IMPORTANT POINTS (FOR CASES 68 AND 69) | 440 | ||
| REFERENCES | 442 | ||
| Case 70 A Woman with Muscle Weakness and Areflexia | 444 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 444 | ||
| WHAT WERE THE EMG FINDINGS? | 446 | ||
| SUMMARY | 447 | ||
| Case 71 An Elderly Woman with Proximal Weakness | 448 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 448 | ||
| WHAT WERE THE EMG FINDINGS? | 450 | ||
| WHAT SHOULD ONE DO NEXT? | 450 | ||
| SUMMARY | 450 | ||
| DISCUSSION (CASES 70 AND 71) | 451 | ||
| IMPORTANT POINTS | 452 | ||
| REFERENCES | 452 | ||
| Case 72 A Young Woman with Distal Upper Extremity Weakness | 454 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 454 | ||
| BASED ON THESE POSSIBILITIES, WHAT TESTS SHOULD BE DONE? | 455 | ||
| WHAT WERE THE EMG FINDINGS? | 457 | ||
| A SECOND EMG TEST WAS PERFORMED | 457 | ||
| WHAT WERE THE FINDINGS OF THE SECOND EMG TEST? | 458 | ||
| WHAT SHOULD BE DONE NEXT? | 458 | ||
| WHAT WERE THE FINDINGS OF THE THIRD EMG TEST? | 459 | ||
| DISCUSSION | 459 | ||
| SUMMARY | 461 | ||
| IMPORTANT POINTS | 461 | ||
| REFERENCES | 462 | ||
| Case 73A A Young Man with Episodic Weakness | 464 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 464 | ||
| WHAT WERE THE EMG FINDINGS? | 465 | ||
| DISCUSSION | 465 | ||
| SUMMARY | 468 | ||
| IMPORTANT POINTS | 468 | ||
| REFERENCES | 468 | ||
| Case 73B An African American Man with Hyperthyroidism and Acute Paralysis | 470 | ||
| DISCUSSION | 470 | ||
| SUMMARY | 470 | ||
| IMPORTANT POINTS | 470 | ||
| REFERENCES | 471 | ||
| Case 74 A Boy with Large Muscles, Leg Pain, and Elevated Serum Creatine Kinase | 472 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 472 | ||
| WHAT SHOULD BE DONE NEXT? | 473 | ||
| WHAT WERE THE EMG FINDINGS? | 474 | ||
| WHAT SHOULD BE DONE NEXT? | 474 | ||
| WHAT SHOULD BE THE NEXT DIAGNOSTIC TEST? | 474 | ||
| WHAT ARE DYSTROPHINOPATHIES? | 474 | ||
| SUMMARY | 478 | ||
| IMPORTANT POINTS | 478 | ||
| REFERENCES | 479 | ||
| Case 75 A Woman with Proximal Muscle Weakness, Calf Hypertrophy, Heel Contractures, and Elevated Serum Creatine Kinase | 480 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 480 | ||
| WHAT WERE THE EMG FINDINGS? | 481 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 481 | ||
| DISCUSSION | 481 | ||
| SUMMARY | 483 | ||
| IMPORTANT POINTS | 483 | ||
| REFERENCES | 483 | ||
| Case 76 A Young Man with Distal Leg Wasting and Normal Sensation | 484 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 484 | ||
| WHAT SHOULD BE DONE NEXT? | 484 | ||
| WHAT WERE THE EMG FINDINGS? | 486 | ||
| WHAT SHOULD BE DONE NEXT? | 486 | ||
| DISCUSSION | 487 | ||
| IMPORTANT POINTS | 491 | ||
| REFERENCES | 492 | ||
| Case 77 A Woman with Droopy Eyelids and Difficulty Swallowing | 493 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 493 | ||
| WHAT WERE THE EMG FINDINGS? | 494 | ||
| WHAT IS THE MEANING OF HUTCHINSON’S, OR ASTRONOMER’S POSTURE? | 495 | ||
| DISCUSSION | 495 | ||
| SUMMARY | 495 | ||
| IMPORTANT POINTS | 495 | ||
| REFERENCES | 496 | ||
| Case 78 A Man with Facial and Shoulder Muscle Weakness | 497 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 497 | ||
| WHAT WERE THE EMG FINDINGS? | 498 | ||
| WHAT SHOULD BE DONE NEXT? | 498 | ||
| DISCUSSION | 498 | ||
| SUMMARY | 500 | ||
| IMPORTANT POINTS | 500 | ||
| REFERENCES | 501 | ||
| Case 79 A Boy Born Floppy with Severe Weakness, and Later, Contractures | 503 | ||
| WHAT WERE THE EMG FINDINGS? | 504 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 504 | ||
| DISCUSSION | 504 | ||
| SUMMARY | 508 | ||
| IMPORTANT POINTS | 508 | ||
| REFERENCES | 508 | ||
| Case 80 A Woman with Long-standing Weakness and Foot Deformities | 510 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 510 | ||
| WHAT TESTS SHOULD BE DONE? | 510 | ||
| WHAT WERE THE EMG FINDINGS? | 511 | ||
| WHAT SHOULD BE DONE NEXT? | 511 | ||
| WHAT ARE CENTRAL CORES? | 511 | ||
| DISCUSSION | 512 | ||
| SUMMARY | 513 | ||
| IMPORTANT POINTS | 513 | ||
| REFERENCES | 514 | ||
| Case 81 A Woman with Droopy Eyelids and Ophthalmoplegia | 515 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 515 | ||
| WHAT SHOULD BE THE WORKUP? | 516 | ||
| WHAT WERE THE EMG FINDINGS? | 518 | ||
| WHAT DOES THIS TEST MEAN? | 518 | ||
| WHAT SHOULD BE DONE NEXT? | 518 | ||
| WHAT IS PROGRESSIVE EXTERNAL OPHTHALMOPLEGIA? | 518 | ||
| WHAT IS THE EXPLANATION FOR THE ENHANCEMENT OF PTOSIS UPON HOLDING THE OPPOSITE EYELID? | 520 | ||
| IMPORTANT POINTS | 521 | ||
| REFERENCES | 521 | ||
| Case 82 A Man with Weakness and Swelling in the Neck | 522 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 522 | ||
| WHAT WERE THE EMG FINDINGS? | 523 | ||
| DISCUSSION | 523 | ||
| SUMMARY | 524 | ||
| IMPORTANT POINTS | 524 | ||
| REFERENCES | 525 | ||
| Case 83 A Woman with Muscle Pains and Dark Urine | 526 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 526 | ||
| WHAT DIAGNOSTIC TESTING SHOULD BE PERFORMED NEXT? | 526 | ||
| WHAT IS RHABDOMYOLYSIS? | 527 | ||
| WHAT WERE THE EMG FINDINGS? | 528 | ||
| DISCUSSION | 528 | ||
| SUMMARY | 530 | ||
| IMPORTANT POINTS | 530 | ||
| REFERENCES | 531 | ||
| Case 84 A Woman with Progressive Proximal Muscle Weakness | 533 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 533 | ||
| WHAT TESTS SHOULD BE DONE? | 533 | ||
| WHAT WERE THE EMG FINDINGS? | 534 | ||
| DISCUSSION | 536 | ||
| SUMMARY | 537 | ||
| IMPORTANT POINTS | 537 | ||
| REFERENCES | 537 | ||
| Case 85 A Sedentary Man with Acute Respiratory Failure and Myoglobinuria | 539 | ||
| WHAT WERE THE EMG FINDINGS? | 540 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 540 | ||
| WHAT OTHER TESTS ARE INDICATED? | 540 | ||
| WHAT SHOULD BE DONE NEXT? | 541 | ||
| DISCUSSION | 541 | ||
| SUMMARY | 543 | ||
| IMPORTANT POINTS | 543 | ||
| REFERENCES | 543 | ||
| Case 86 A Uremic Man with Proximal Muscle Weakness | 545 | ||
| WHAT SHOULD BE DONE NEXT? | 545 | ||
| WHAT WERE THE EMG FINDINGS? | 547 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 547 | ||
| DISCUSSION | 547 | ||
| SUMMARY | 548 | ||
| IMPORTANT POINTS | 548 | ||
| REFERENCES | 548 | ||
| Case 87 A Woman with Weakness, Elevated Cholesterol, and Serum Creatine Kinase Levels | 550 | ||
| WHAT WERE THE EMG FINDINGS? | 551 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 551 | ||
| WHAT SHOULD BE DONE NEXT? | 551 | ||
| DISCUSSION | 551 | ||
| SUMMARY | 552 | ||
| IMPORTANT POINTS | 552 | ||
| REFERENCES | 553 | ||
| Case 88 An Older Woman with Leg Weakness and Atrophic Muscle Fibers on Biopsy | 554 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 554 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 554 | ||
| WHAT WERE THE EMG FINDINGS? | 555 | ||
| WHAT DO THESE TESTS SUGGEST? | 556 | ||
| WHAT OTHER TESTS NEED TO BE DONE? | 556 | ||
| DISCUSSION | 556 | ||
| SUMMARY | 558 | ||
| IMPORTANT POINTS | 558 | ||
| REFERENCES | 558 | ||
| Case 89A A Woman with Muscle Weakness and a Skin Rash | 559 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 559 | ||
| WHAT SHOULD BE DONE NEXT? | 559 | ||
| WHAT WERE THE EMG FINDINGS? | 561 | ||
| WHAT SHOULD BE DONE NEXT? | 561 | ||
| Case 89B A Child with Muscle Weakness and a Skin Rash | 562 | ||
| WHAT WERE THE EMG FINDINGS? | 563 | ||
| WHAT IS THE MOST LIKELY DIFFERENTIAL DIAGNOSIS? | 563 | ||
| DISCUSSION (CASES 89A AND 89B) | 563 | ||
| SUMMARY | 565 | ||
| IMPORTANT POINTS | 565 | ||
| REFERENCES | 565 | ||
| Case 90 A Man with Muscle Pains | 567 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 567 | ||
| WHAT WERE THE EMG FINDINGS? | 568 | ||
| WHAT SHOULD BE DONE NEXT? | 568 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 568 | ||
| WHAT WERE THE FINDINGS OF THE SECOND TEST? | 570 | ||
| WHAT SHOULD BE DONE NEXT? | 570 | ||
| DISCUSSION | 570 | ||
| SUMMARY | 570 | ||
| IMPORTANT POINTS | 571 | ||
| REFERENCES | 571 | ||
| Case 91 An Older Woman with Progressive Muscle Weakness | 572 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 572 | ||
| WHAT WERE THE EMG FINDINGS? | 573 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS GIVEN THESE EMG FINDINGS? | 573 | ||
| WHAT SHOULD BE DONE NEXT? | 574 | ||
| DISCUSSION | 574 | ||
| SUMMARY | 576 | ||
| IMPORTANT POINTS | 576 | ||
| REFERENCES | 576 | ||
| Case 92 An HIV-Infected Man with Muscle Weakness and Spasms | 577 | ||
| WHAT WERE THE EMG FINDINGS? | 578 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 578 | ||
| DISCUSSION | 579 | ||
| SUMMARY | 580 | ||
| IMPORTANT POINTS | 580 | ||
| REFERENCES | 580 | ||
| Case 93 A Woman with Limb Swelling and Pain | 581 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 581 | ||
| WHAT SHOULD BE DONE NEXT? | 581 | ||
| WHAT IS THE TREATMENT? | 581 | ||
| DISCUSSION | 582 | ||
| SUMMARY | 583 | ||
| IMPORTANT POINTS | 583 | ||
| REFERENCES | 583 | ||
| Case 94 A Man with a Bent Spine | 584 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 584 | ||
| WHAT TESTS SHOULD BE DONE? | 584 | ||
| WHAT WERE THE EMG FINDINGS? | 585 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 585 | ||
| WHAT SHOULD BE DONE NEXT? | 585 | ||
| DISCUSSION | 585 | ||
| SUMMARY | 587 | ||
| IMPORTANT POINTS | 587 | ||
| REFERENCES | 587 | ||
| Case 95 A Man with Muscle Stiffness, and Later with Diplopia | 588 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 588 | ||
| WHAT WERE THE EMG FINDINGS? | 589 | ||
| Case 96 A Woman with Muscle Cramps and Fasciculations | 594 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 594 | ||
| WHAT WERE THE EMG FINDINGS? | 595 | ||
| WHAT OTHER TESTS SHOULD BE DONE? | 596 | ||
| DISCUSSION | 596 | ||
| SUMMARY | 597 | ||
| IMPORTANT POINTS | 597 | ||
| REFERENCES | 600 | ||
| Case 97 A Man with Large and Stiff Muscles | 601 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 601 | ||
| WHAT WERE THE EMG FINDINGS? | 603 | ||
| DISCUSSION | 603 | ||
| WHAT CAUSES MYOTONIA? | 603 | ||
| WHAT IS THE TREATMENT OF MYOTONIA CONGENITA? | 606 | ||
| SUMMARY | 606 | ||
| IMPORTANT POINTS | 606 | ||
| REFERENCES | 608 | ||
| Case 98 A Boy with Short Stature, Small Jaw, Muscle Hypertrophy, and Stiffness | 609 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 609 | ||
| WHAT WERE THE EMG FINDINGS? | 610 | ||
| WHAT IS SCHWARTZ-JAMPEL SYNDROME? | 610 | ||
| SUMMARY | 611 | ||
| IMPORTANT POINTS | 611 | ||
| REFERENCES | 611 | ||
| Case 99 An Elderly Woman with Muscle Spasms | 612 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 612 | ||
| WHAT WERE THE EMG FINDINGS? | 613 | ||
| WHAT SHOULD BE DONE NEXT? | 613 | ||
| DISCUSSION | 614 | ||
| SUMMARY | 614 | ||
| IMPORTANT POINTS | 614 | ||
| REFERENCES | 614 | ||
| Case 100 A Woman with Proximal Muscle Weakness and Neuromuscular Irritability | 616 | ||
| WHAT WERE THE EMG FINDINGS? | 617 | ||
| WHAT IS THE MOST LIKELY DIAGNOSIS? | 617 | ||
| WHAT SHOULD BE DONE NEXT? | 618 | ||
| DISCUSSION | 618 | ||
| SUMMARY | 619 | ||
| IMPORTANT POINTS | 619 | ||
| REFERENCES | 619 | ||
| Case 101 A Woman with Focal Spontaneous Muscle Movements | 620 | ||
| WHAT IS THE DIFFERENTIAL DIAGNOSIS? | 620 | ||
| WHAT WERE THE EMG FINDINGS? | 622 | ||
| DISCUSSION | 622 | ||
| SUMMARY | 623 | ||
| IMPORTANT POINTS | 623 | ||
| REFERENCES | 623 | ||
| Index of Cases by Diagnosis | 625 | ||
| Index | 629 |