Neurology

Question 1

What clinical exam features should make you consider a myopathy?

Answer 1

Face: frontal balding, ptosis, facial weakness, cataracts
Waddling gait
Protuberant abdomen/scoliosis
Muscle wasting - especially limb girdle, ant tibialis
Proximal pattern of weakness
Normal sensation
Normal reflexes

Question 2

What are possible causes of myopathy?

Answer 2

Divide into acquired and hereditary
Acquired would include drug related or inflammatory. Drug related = statins, zidovudine, colchicine, steroids. Inflammatory: IBM, polymyositis, dermatomyositis
Hereditary: mitochondrial, muscular dystrophy, myotonic dystrophy

Question 3

What are common types of muscular dystrophy

Answer 3

Becker, limb girdle, distal, FSH, Emery- dreifuss, oculopharengyl

Question 4

What findings would you expect on EMG for a myopathy?

Answer 4

Fibrillations (may suggest inflammatory cause)
Early recruitment
Low amplitude, polyphasic, short duration units