BrainWaves: A Neurology Podcast

#158 Teaching through clinical cases: A primer on proximal weakness

BrainWaves: A Neurology Podcast

Generalized weakness is a common complaint. Much of the time, we as neurologists don’t even see these patients in the hospital or the clinic. But more often than not, “generalized” weakness may be the only way a patient describes difficulty brushing their hair or climbing stairs. In these situations, it’s not exactly generalized weakness. It’s something else. This week on BrainWaves, we review the major patterns of weakness that characterize the most common muscle disorders. With a quick review of EMG findings. Enjoy!

Produced by James E. Siegler. Music courtesy of Jahzzar, Kevin McLeod, Patches, and Montplaisir. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

  1. Suresh E and Wimalaratna S. Proximal myopathy: diagnostic approach and initial management. Postgraduate medical journal. 2013;89:470-7.
  2. Walter MC, Reilich P, Thiele S, Schessl J, Schreiber H, Reiners K, Kress W, Muller-Reible C, Vorgerd M, Urban P, Schrank B, Deschauer M, Schlotter-Weigel B, Kohnen R and Lochmuller H. Treatment of dysferlinopathy with deflazacort: a double-blind, placebo-controlled clinical trial. Orphanet J Rare Dis. 2013;8:26.
  3. Fayssoil A, Ogna A, Chaffaut C, Chevret S, Guimaraes-Costa R, Leturcq F, Wahbi K, Prigent H, Lofaso F, Nardi O, Clair B, Behin A, Stojkovic T, Laforet P, Orlikowski D and Annane D. Natural History of Cardiac and Respiratory Involvement, Prognosis and Predictive Factors for Long-Term Survival in Adult Patients with Limb Girdle Muscular Dystrophies Type 2C and 2D. PloS one. 2016;11:e0153095.
  4. Harris E, Bladen CL, Mayhew A, James M, Bettinson K, Moore U, Smith FE, Rufibach L, Cnaan A, Bharucha-Goebel DX, Blamire AM, Bravver E, Carlier PG, Day JW, Diaz-Manera J, Eagle M, Grieben U, Harms M, Jones KJ, Lochmuller H, Mendell JR, Mori-Yoshimura M, Paradas C, Pegoraro E, Pestronk A, Salort-Campana E, Schreiber-Katz O, Semplicini C, Spuler S, Stojkovic T, Straub V, Takeda S, Rocha CT, Walter MC, Bushby K and Jain COSC. The Clinical Outcome Study for dysferlinopathy: An international multicenter study. Neurol Genet. 2016;2:e89.
  5. Clark KEN and Isenberg DA. A review of inflammatory idiopathic myopathy focusing on polymyositis. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2018;25:13-23.
  6. Wicklund MP. The Limb-Girdle Muscular Dystrophies. Continuum (Minneap Minn). 2019;25:1599-1618.
  7. Preston DC and Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. 3rd ed. London; New York: Elsevier Saunders; 2013.
  8. “rAAVrh74.MHCK7.DYSF.DV for Treatment of Dysferlinopathies.” Clinicaltrials.gov. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02710500?cond=dysferlinopathy&draw=2&rank=1 on 22 December 2019.

For great video examples of EMG findings in nerve and muscle disease, check out KImura & Kohara's YouTube recordings: https://www.youtube.com/watch?v=6-3PP_S-Q8I&list=PLCC_NQWOABCY18PEzlGELGOR_-IDNaDQ_

Next Episodes