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Neuromuscular Disease - Coggle Diagram
Neuromuscular Disease
History
Look for
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- Presence or absence of other neuro sings
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- Sensory distrubance
Positive
Negative
- Motor weakness
Proximal
Distal
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- Wasting, fasciculations, cramps
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- Associated symptoms
NM: Swallow, resp, cardiac, bulbar
Systemic: rash, weight loss, dry eyes, mouth, sweats
- Functional impairement
Walking aids
Splints
ADLS
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- Fhx cardiomyopathy / PPM
Myopathy, muscular dystrophy, familial amyloid polyneuropathy
- Fhx migrain, epilepsy , diabetes (mitochondrial)
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Exam
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Muscular Inspection
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- Foot / joint / spine abnormalities
Muscle Strength
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Distribution
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Distal , length dependent = nerve
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NMJ Disorders
Immune mediated
- Myasthenia gravis (including transient neonatal MG)
- Lambert Eotin myasthenic syndromes (LEMS)
Toxic / Metabolic
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- Snake / spider venom poisning
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Neurophysiology
- Repetive Nerve Stimulation (RNS)
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- Tensilon (Edrophonium) test
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Diabetic Neuropathy
Types
- Mononeuropathy including cranial
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- Symmetrical length deprendent sensory > Motor polyneuropathy
- Treatment related diabetic neuropathy (insulin neuritis)
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LEMS Vs MG
LEM
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- Reflexes reduced / absent
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- FAcilitation post exercise
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Treatment MG
- Pyridostigmine (anticholinesterase)
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