A Case-Based Guide to Neuromuscular Pathology

Lan Zhou, MD, PhD Departments of Neurology and PathologyBoston University Medical CenterBoston, MA USA Dennis K. Burns, MDDepartment of PathologyNeuropathology SectionThe University of Texas Southwestern Medical CenterDallas, TX USA Chunyu Cai, MD, PhDDepartment of PathologyThe University of Texas Southwestern Medical CenterDallas, TX

Part I: Introduction to Neuromuscular Pathology Evaluation.-1. Skeletal Muscle Biopsy Evaluation.-2. Peripheral Nerve Biopsy Evaluation.-3. Skin Biopsy with Cutaneous Nerve Fiber Evaluation.-Part II: Myopathy Cases.-4. A 20-year-old man with acute multi-organ failure and rhabdomyolysis.-5. A 45-year-old woman with proximal limb weakness and skin peeling on fingertips.-6. A 75-year-old man with leg and hand weakness.-7. A 53-year-old woman with proximal limb weakness and marked CK elevation.-8. A 61-year-old woman with distal limb and deltoid weakness.-9. A 63-year-old woman with debilitating muscle pain.-10. A 33-year-old woman with pain and swelling in the right calf and persistent fever.-11. A 28-year-old woman with proximal limb weakness and scapular winging.-12. A 52-year-old man with proximal limb weakness and hand stiffness.-13. A 51-year-old woman with long-standing exercise intolerance.-14. A 37-year-old woman with leg weakness.-15. A 25-year-old woman with droopy eyelids and double vision.-16. A 58-year-old man with hypercapnic respiratory failure.-17. A 65-year-old man with asymmetrical leg weakness and foot tingling.-18. A 40-year-old man with muscle pain and fatigue.-19. A 42-year-old woman with progressive limb weakness and breathing difficulty.-20. A 49-year-old man with limb weakness and skin changes.-21. A 54-year-old man with lower limb weakness.-22. A 63-year-old man with progressive limb weakness and slurred speech.-23. A 6-year-old girl with muscle pain and swelling in the thighs.-24. A 4-year-old boy with progressive weakness, difficulty walking and running, and increased falls.-25. A 2-year-old girl with hypotonia since birth and delayed motor and speech development.-26. An 8-year-old boy with delayed motor milestones and proximal leg muscle weakness.-27. A 6-year-old-boy with proximal leg muscle weakness and facial weakness.-28. A 6-week-old boy with neonatal hypotonia and feeding and respiratory difficulties.-29. A 6-year-old boy with respiratory and feeding difficulties at birth, delayed gross motor milestones, and facial and proximal lower limb weakness.-30. A 12-year-old girl with a 2-year history of progressive weakness and difficulties with exercise.-31. A 3-month-old boy with generalized hypotonia, weakness, pneumonia and respiratory failure.-Part III: Neuropathy Cases.-32. A 59-year-old woman with subacute lower limb weakness and painful paresthesia.-33. A 63-year-old man with nausea, vomiting, orthostatic dizziness, and distal limb paresthesia.-34. A 47-year-old woman with progressive numbness and weakness in the limbs.-35. A 65-year-old woman with acute limb weakness and worsening of paresthesia.-36. A 34-year-old man with right hand and left foot numbness.-37. A 64-year-old woman with progressive pain, numbness and weakness in the right lower limb.-38. A 68-year-old man with progressive lower limb numbness and weakness and urinary incontinence.-39. A 53-year-old woman with pain, burning, tingling, and numbnessin the distal limbs.-40. A 40-year-old woman with patchy painful paresthesia.-41. A 39-year-old woman with intermittent bilateral foot and leg pain since childhood.- 42. A 35-year-old man with pain and numbness in the left lateral thigh.