Neuromuscular Disease

Hadi Manji MA MD FRCP, Chris Turner FRCP PhD, Matthew R. B. Evans MBBS MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London

Section 1: Peripheral nerve, neuromuscular junction and motor
neuron disorders.- A woman who could
not wear high heels.- Rare as rocking horse droppings…- A lady with ataxia – an
example of Hickam’s Dictum.- A lady with tremor not due to Parkinson’s
disease.- A makeup artist with Crohn’s disease.- Not a laughing matter.- Leg
swelling and painful feet in a business man.- A man with back pain and weight
loss.- A man with progressive weakness and muscle twitching.- A woman with
burning hands.- Another case of unsteadiness.- A young man with blurred vision
and foot drop.- Progressive motor weakness in a Somalian man.- A man with a
pacemaker develops difficulty walking.- Cramps, weakness and fasciculations.- A
lady with weakness since childhood.- A man with an insidious, painful
mononeuropathy.- A lady with head drop.- The dangers of home preserved
vegetables.- A man with a dry mouth and weakness.- A man with difficulty
chewing gum and an ominous family history.- A patient with anacute syndrome,
recovers and represents years later.- A man with recurrent chest infections.- A
medical student with episodes of weakness and sensory disturbance.- Weakness in
an Indian man.- A man with episodes of shoulder pain and a weak arm.- A man
with painful feet and hand ulcers.- A psychologist with wrist drop.- Section 2: Muscle disorders.- Longstanding
drooping eyelids.- Drooping eyelids PLUS.- Neither one nor the other.- When is
myotonia not caused by myotonic dystrophy?.- Myotonia and paralysis-two
syndromes, one diagnosis.- Typical phenotype, MRI and histology.- Atypical
phenotype, MRI and histology.-  A multisystem muscle disorder needs
monitoring.- The less aggressive and less common cousin.- A common cause of
progressive proximal weakness...- ... and the other common cause.-  A
treatable systemic muscle disease.- A blood vessel disease causing weakness.-
Antibody-mediated muscle disease?.- When the wind comes back.- When the wind
does not come back.- Paralysis is only a part of the problem.- “Back to the
basics”-never forget to look at the back.- Is it time to take the heat out of
the problem?.- Praying for an answer can be helpful.- Neuromuscular junction
dysfunction is not always myasthenic.- Carrying shopping can be difficult,
especially for men.