News Express
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FREE Webinar - What a PM&R Physician Needs to Know About Considering a Career in NM or EDX Medicine
October 27, 2022
AANEM invites medical students, residents, and early-career physiatrists to join experienced physicians at an interactive webinar to explore career options for physiatrists with a sub-specialty focus on neuromuscular (NM) and/or electrodiagnostic (EDX) medicine.
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Patient Safety: Percutaneous Sharp Injuries: Primary Prevention
October 17, 2022
Patient Safety: Percutaneous Sharp Injuries: Primary Prevention
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Science News: Eculizumab Versus Rituximab in Generalised Myasthenia Gravis
October 16, 2022
A small sub-group of myasthenia gravis (MG) patients is refractory to first-line immunosuppressive medications. Complement-targeted therapies are relatively new in neurological practice but gaining grounds in the landscape of MG management, particularly acetylcholine receptor antibody (AChR)-Ab positive cases.
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Science News: Measurement of Excitation-Contraction Coupling Time in Critical Illness Myopathy
October 02, 2022
This study describes a novel electrophysiological method using an accelerometer to measure the excitation-contraction coupling of the soleus muscle for early diagnosis of critical illness myopathy (CIM).
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World Limb Girdle Muscular Dystrophy (LGMD) Awareness Day
September 29, 2022
World Limb Girdle Muscular Dystrophy (LGMD) Awareness Day
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AANEM Consensus Statement Collaboration with the Heart Rhythm Society
September 13, 2022
The Heart Rhythm Society (HRS) recently published in their journal an international multidisciplinary document titled 2022 HRS Expert Consensus Statement on Evaluation and Management of Arrhythmic Risk in Neuromuscular Disorders that AANEM is pleased to have collaborated on. This document is intended to guide electrophysiologists, cardiologists, other clinicians, and health care professionals in caring for patients with arrhythmic complications of neuromuscular disorders (NMDs).
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Science News: Identification of Serum Interleukin 6 Levels as a Disease Severity Biomarker in Facioscapulohumeral Muscular Dystrophy
May 15, 2022
Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common inherited myopathies, presenting as slowly progressive, often asymmetric muscle weakness. Although a gain-of-toxic function secondary to aberrant DUX4 expression is the known etiology, exact pathomechanism is not known. Inflammatory reactions are sometimes seen in muscle biopsies, leading to speculation of the role of inflammatory pathway activation in disease pathogenesis. This retrospective study analyzed serum cytokines in 100 FSHD1 patients to identify potential biomarkers.
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Science News: Systemic Inflammatory Markers in Neuropathic Pain, Nerve Injury, and Recovery
May 15, 2022
Findings of this article highlight the potential role of systemic immune dysregulation and the role of cytokines in focal nerve injury and chronic neuropathic pain. The study provides important information relevant to neuropathic pain and possible biomarkers for future studies. Findings of this article highlight the potential role of systemic immune dysregulation and the role of cytokines in focal nerve injury and chronic neuropathic pain. The study provides important information relevant to neuropathic pain and possible biomarkers for future studies.
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Science News: Effects of Transcranial Direct Current Stimulation Combined with Neuromuscular Electrical Stimulation on Upper Extremity Motor Function in Patients with Stroke
April 28, 2022
This study determines the treatment effects of transcranial direct current stimulation (tDCS) combined with neuromuscular electrical stimulation (NMES) on the motor function of upper extremity (UE) in persons with stroke. The study allows for additive tools physicians can utilize to optimize and improve upon conventional rehabilitation.
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Science News: Home-Based Exercise in Autoimmune Myasthenia Gravis: A Randomized Controlled Trial
April 28, 2022
Currently, no evidence-based guideline exists on the amount and type of exercise in the patient with generalized MG and effects on the quality of life. In this study, the authors tried to analyze home-based exercise over a home rowing program over 3 months. Although the exercise was well tolerated, the intention to treat analysis revealed no evidence of improved health-related quality of life.
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Science News: Natural History of Facioscapulohumeral Dystrophy in Children: A 2-Year Follow-Up
April 18, 2022
This is a small 2-year follow-up study of genetically confirmed facioscapulohumeral dystrophy (FSHD) cases from the Netherlands. On clinical examination, facial weakness was observed as a sign of disease progression. FSHD clinical score 0-15 and muscle ultrasound Z score appeared to be most promising outcome measures of progression. Despite disease progression, children may still notice improvement in functional capacity, including the 6-minute walk test. Pain, fatigue, and decreased quality of life were common symptoms during follow-up.
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Science News: Mitochondrial Disease in Adults: Recent Advances and Future Promise
April 18, 2022
This article provides an up-to-date review of the clinical and biochemical approach to mitochondrial disorders in adults. The clinical approach algorithm is especially useful. The NM neuro-imaging features will also help clinicians.
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Science News: Life Expectancy in Duchenne Muscular Dystrophy: Reproduced Individual Patient Data Meta-Analysis
April 03, 2022
This is a systemic review of published literature on mortality in Duchenne muscular dystroph (DMD) up to July 2020 which focused on publications with Kaplan-Meier (KM) survival curves with age as a time scale. Of the 1,177 articles identified, 14 publications met the inclusion criteria providing data on 2,283 patients of whom 1,049 had died. Median life expectancy was 22 years. Analysis stratified by 3 time periods showed increased life expectancy in more recent patient populations born after 1990 had a median life expectancy of 28.1 years.
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Science News: Clinical and Genetic Characteristics in Young, Glucocorticoid-Naïve Boys With Duchenne Muscular Dystrophy
April 03, 2022
This article reports the genotype-phenotype characteristics of the largest international cohort of Duchenne muscular dystrophy (DMD) boys (participants in the Finding the Optimum Corticosteroid Regime for Duchenne Muscular Dystrophy (FOR-DMD)) pretreated with glucocorticoids. Out of 196 boys recruited, 193 were found to have a DMD mutation.
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Science News: Ultrasound First for Pediatric Patients in an Electrodiagnostic Laboratory
March 20, 2022
Authors investigated the impact of a US-first approach, adopted in their EMG lab, for pediatric patients. They retrospectively identified pediatric patients who were examined via US prior to EDX tests and those undergoing EDX tests initially. Authors compared the number of nerves stimulated in NCS and the number of muscles sampled in EMG between groups. They also presented two cases to demonstrate the impact of using a US-first approach.
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Science News: Is There an Association Between Ulnar Nerve Hypermobility and Neuropathy at the Elbow?
March 20, 2022
This is a review of literature regarding associations between ulnar nerve hypermobility (UNH) and ulnar neuropathy at the elbow (UNE). Case control, cohort, and RCTs were included. Studies diagnosing UNH both with physical exam (3) and US (17) were included. Diagnosis was made with both electrodiagnostic studies and ultrasonography. Studies looking at post op findings, hereditary neuropathy with liability to pressure palsy, polyneuropathy, trauma, and pediatric cases were included. Cadaveric or animal studies were excluded.
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Science News: Nitrous Oxide-Induced Myeloneuropathy
March 06, 2022
Nitrous oxide (NO, also known as laughing gas, balloons, whippets) abuse is increasingly recognized as an issue worldwide. Prolonged NO misuse inactivates vitamin B12, causing combined subacute degeneration. The authors studied a cohort of 20 patients with NO misuse. The average patient age was 24 years and mean canister consumption was 148 per day for 9 months. Common presentation included sensory symptoms with paresthesias and gait unsteadiness. In severe cases, patients were bedbound.
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Science News: Variable Presentation of Hereditary Transthyretin-Mediated Amyloidosis at a Single Center
March 06, 2022
This is a retrospective study of 12 patients with a diagnosis of hereditary transthyretin-mediated (hATTR) amyloidosis at a single center in Austin, Texas. All patients were initially diagnosed with either polyneuropathy (83%) or myopathy (25%). Eventually these patients were all diagnosed with haTTR amyloidosis. The median time to diagnosis for these patients was 5 years (up to 10 years) during which their mobility had declined significantly.
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Remembering Jun Kimura
March 06, 2022
AANEM Past President and electrodiagnostic pioneer Jun Kimura, MD, passed away on Thursday, March 3, 2022, at the age of 87.
"Dr. Kimura is truly a legend in both neurology and electrodiagnostic medicine and his impact on our disciplines cannot be overstated. His selfless and tireless teaching improved the quality of medical care across the globe. He was both a great person and truly good person that touched so many lives. I know I speak for many when I say that we will deeply miss our dear friend and mentor," said Dr. Jeff Strakowski. -
Science News: An Approach to Assessing Immunoglobulin Dependence in Chronic Inflammatory Demyelinating Inflammatory Polyneuropathy
March 06, 2022
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a peripheral nerve disease coursing with weakness and impaired sensation. The course tends to be relapsing-remitting or progressive if left untreated. While there is evidence to support treatment with IVIg, plasma exchange, or steroid therapy and consensus on how to identify and monitor patients needing a protracted treatment course, data on when and how to stop therapy and identify remission is lacking. The authors of this paper sought to elucidate IVIg treatment cessation strategies in CIDP.