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Facilitators What’s On Your Mind? FACILITATORS Facilitator in Chief and Founding Facilitator Richard J. Barohn, M.D., Executive Vice Chancellor for Health Affairs, University of Missouri and Distinguished Emeritus Professor, University of Kansas Medical Center Associate Facilitators Jonathan S. Katz, M.D., Director, The Forbes Norris MDA/ALS Research and Treatment Center Todd Levine, M.D., Medical Director, HonorHealth Neuroscience Institute Mamatha Pasnoor, M.D., Associate Professor, Dept. of Neurology, University of Kansas Medical Center Mazen Dimachkie, M.D., Professor of Neurology & Director of Neuromuscular Division, Executive Vice Chairman & Vice Chairman for Research, Dept. of Neurology University of Kansas Medical Center Gil Wolfe, M.D., Irvin & Rosemary Smith Professor & Chairman, Dept. of Neurology, University at Buffalo/SUNY Dave Saperstein, M.D., Director, Center for Complex Neurology, EDS & POTS Aziz Shaibani, M.D., FACP, FAAN, Clinical Professor of Medicine, Baylor College of Medicine, and Director, Nerve and Muscle Center of Texas Tahseen Mozaffar, M.D., Director, UC Irvine-MDA ALS and Neuromuscular Center, Neurology School of Medicine Erik Ensrud, M.D., Associate Professor of Orthopaedics and Rehabilitation, Oregon Health & Science University School of Medicine John Kissel, M.D., Chair of Neurology(ret.), Ohio State University Wexner Medical Center Laura Herbelin, EMG Technician and Research Instructor (ret), Neurology , University of Kansas Medical Center Raghav Govindarajan, M.D., Assistant Professor of Neurology, University of Missouri School of Medicine William Campbell, M.D., Professor Emeritus, Department of Neurology, Uniformed Services University Yuebing Li, M.D., Staff Neurologist, Neuromuscular Center, the Cleveland Clinic Foundation Publishing Facilitator Marianne Reed, Digital Publishing Services, University of Kansas Libraries Cover Image: “Portret van Rembrandt n. B. 320, Thomas Worlidge, 1710–1766” by Thomas Worlidge is licensed under CC0 1.0. https://www.rijksmuseum.nl/en/collection/RP-P-1953-734 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial 1 No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/) 1 CONTENTS WHATS ON YOUR MIND? What’s In This Issue 1 Richard J. Barohn, MD COVID-19 and COVID-1619: Letter from the Founding Facilitator 1 Richard J. Barohn, MD “A Great Yankee’s Indian Summer: Did Lou Gehrig Experience a Temporary ALS Reversal While Playing in August 1938?” 2 Richard Bedlack MD, PhD and Dan Joseph NEW DISCOVERIES/NEW STUFF Obstetric-Gynecological Complications in Neuromuscular Disorders 5 Lakshmi P. Digala MBBS, Zahra Haider BS, and Raghav Govindarajan MD Myasthenia Gravis Mimicking Acute Cerebrovascular Events 9 Lakshmi P. Digala MBBS, Emily Bailey BS, and Raghav Govindarajan MD LOOKING BACK AND LOOKING FORWARD AT STUFF Neuromuscular Complications in COVID-19: A Review of the Literature 13 Tiffany Pike-Lee, MD, Yuebing, Li, MD, PhD and Gil I. Wolfe, MD CLINIC STUFF Rhabdomyolysis and COVID-19 Infection: Is It Due to Statin Use or Anti-TIF1-y Antibodies? 22 Emmanuel C. Mantilla, Mamatha Pasnoor and Mazen M. Dimachkie Transthyretin Familial Amyloid Polyneuropathy Mimicking Chronic Inflammatory Demyelinating Polyneuropathy: Familial Amyloid Polyneuropathy Case Report 26 Amanda J. Thuringer DO, Omar H. Jawdat MD, Mazen M. Dimachkie MD VISUAL STUFF Progression of Charcot-Marie-Tooth Foot and Hand Deformities in a Family with CMT1A 32 Kristyn Pocock MD and Tuan H. Vu MD PROPOSED STUFF Comparative Effectiveness Study of Treatment of Sialorrhea in Patients with ALS 34 Richard J. Barohn, Byron Gajewski, Jeffrey Statland, Laura Herbelin, Russ Waitman, Kim Kimminau MEETING STUFF Health Sciences Research Day at University of Missouri, 2019 79 Raghav Govindarajan MD This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/) 2 What’s On Your Mind? What’s In This Issue? COVID-19 and COVID-1619 Letter from the Founding Facilitator There are two other pieces in the What’s On Your Mind section. One are some thoughts I wanted to pass on regard- Keywords: COVID-19, Civil War, Civil Rights, COVID-1619, ing the racial inequities issues that I had heard on the radio. Jim Crow The radio story talked about two “viral” epidemics.... the COVID- 19 epidemic and the epidemic of slavery. This is I heard an amazing news story recently this week that such an important problem in our society that I wanted to many of you may have heard as well. Pastor Raphael G. included it in this issue. Then Dr Bedlack has a nice piece Warnock, PhD from the Ebenezer Baptist church in Atlanta reflecting on Lou Gehrig’s battle with ALS and did he in fact was interviewed. He also happens to be running for the have a reversal (? Or plateau) based on an analysis of his senate in Georgia. This of course is the church where Martin baseball metrics. In the New Discoveries/New Stuff section Luther King, Jr was a preacher too. Reverend Warnock we have two papers by the University of Missouri-Columbia said we are dealing with two viral plagues. COVID-19 group (my new institution!) led by Dr Govindarajan : one on and COVID-1619. COVID-19 came on our shores around obstetrics-gynecological complications of neuromuscular January or February of this year and appeared in the world disorders and the other on a series of patients presenting shortly before that. As our scientist across the world are with myasthenia gravis that mimicked stroke events. Since working on a vaccine for COVID-19, there is a concern that COVID- 19 is the medical topic of the day, I asked two of our the virus can mutate so that it will be difficult to come up associate facilitators to write a piece for the “Looking Back with an effective vaccine, or that the vaccine will have to and Looking Forward at Stuff “ section on the neuromus- be altered frequently, such as is done with the influenza flu cular complications of COVID-19. Drs GIl Wolfe and Yue- vaccine. COVID-1619 appeared on our shores in the year bing Li enlisted Dr. Tiffany Pike-Lee to be the lead author 1619 when the first 50 African slaves were brought to the on this important review article. In “Clinic Stuff” we have a colony of Jamestown in Virginia to serve as slave labor. case from Dr. Mantilla and KUMC group where he trained We have been plagued with the 1619 virus ever since. The on a case of COVID-19 and rhabdomyolysis in the setting of American Revolution in the late 1700s did nothing to stamp statin use as well as a fascinating case , also from the KUMC out this virus. The Civil War in the mid-1800s was the first group, on a case of hereditary amyloidosis with neuropathy attempt to “treat” this horrible infection on our land and had that initially resembled CIDP. The “Visual Stuff” contribu- some remarkable success. But that success was soon rolled tion is from Drs Pocock and Vu at the University of South back as COVID-1619 mutated into the Jim Crow south and Florida where they show dramatic pictures of the effects of throughout the nation as we endured government accepted CMT on the hands and feet over three generations. For the segregation for nearly 100 years. Then the Civil Rights “Proposed Stuff” section I offered the never funded grant movement led by Martin Luther King, Jr and others made myself and KUMC colleagues submitted to the Patient Cen- remarkable progress through peaceful protests to change legislation in the USA to give equal rights to all races. Again, ters for Outcomes Research (PCORI) in which we proposed for the last 50 years we have seen a dramatic rollback of that to compare four different drug therapies for excess sialor- success with the next COVID-1619 mutation and the rise rhea in patients with ALS. If nothing else, the readers of the of mass incarceration and judicial system injustice toward journal can see how we put together that PCORI grant. I still African Americans and in particular African American men. think it is a worthy study but I do not think PCORI finds it an Now we have the opportunity to once again have a societal interesting enough problem to fund. Finally, for the “Meet- therapeutic approach to racial injustice by saying we will ing Stuff” section I asked Dr Govindarajan to publish the ab- not tolerate this form of injustice any longer. The time has at stracts the University of Missouri Neurology Departments long last come for meaningful, real change. I need to be part research day last year. I want to offer this journal as a place of this new movement for social change. Let’s attack both to have any neurology department or neuromuscular fellow- COVID-19 and COVID-1619 so they never come back. ship program to publish their annual research day abstracts. It’s not too late to submit your research day abstracts from Rick the academic year that just ended. Rick RRNMF Neuromuscular Journal 2020;1(3):1 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial 1 No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/) What’s On Your Mind? “A Great Yankee’s Indian Summer: In early 1938, Lou Gehrig experienced the first symp- Did Lou Gehrig Experience a toms of the disease that would eventually bear his name and 6 Temporary ALS Reversal While Playing in take his life. In spring training, sportswriters noticed he August 1938?” was not hitting the ball as hard as usual, and Gehrig himself said his hits lacked “the proper zoom.”7 He opened the regu- Richard Bedlack MD, PhD1 and Dan Joseph2 lar season in a deep slump, and by early August, his batting 1Duke University Department of Neurology, average, home run total and overall run production were Durham NC USA well below his career norms.8 Several sportswriters said the 2Olney MD USA “Iron Horse” should end his renowned consecutive games ABSTRACT streak, which by then stretched for more than two thousand Nineteen thirty-eight was the last full season played by games over 13 years.
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