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

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 5, 2020

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

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Fayssoil A, Ogna A, Chaffaut C, et al. 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(4):e0153095. PMID 27120200

Harris E, Bladen CL, Mayhew A, et al. The Clinical Outcome Study for dysferlinopathy: An international multicenter study. Neurol Genet 2016;2(4):e89. PMID 27602406

Preston DC and Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. 3rd ed. London; New York: Elsevier Saunders; 2013.

Suresh E, Wimalaratna S. Proximal myopathy: diagnostic approach and initial management. Postgrad Med J 2013;89(1054):470-7. PMID 23596213

Walter MC, Reilich P, Thiele S, et al. Treatment of dysferlinopathy with deflazacort: a double-blind, placebo-controlled clinical trial. Orphanet J Rare Dis 2013;8:26. PMID 23406536

Wicklund MP. The limb-girdle muscular dystrophies. Continuum (Minneap Minn) 2019;25(6):1599-618. PMID 31794462

rAAVrh74.MHCK7.DYSF.DV for Treatment of Dysferlinopathies. Clinicaltrials.gov: https://www.clinicaltrials.gov/ct2/show/NCT0271050022. Accessed 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...

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.