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General Disease Finder General Disease Finder This overview will help to fnd neuromuscular disease patterns in the different sections. Addison’s disease: Cushing’s disease: steroid myopathy, general muscle weakness Adrenal dysfunction CN: VII AIDS CMV: polyradiculomyelopathy Herpes zoster: radiculitis Immune Reconstitution Infammatory Syndrome (IRIS) Infections: aspergillus, candida, CMV, cryptococcus, histoplasma, HSV, TBC, toxoplasmosis, varicella Myopathies: infammatory, treatment related Neoplastic: lymphoma (direct nerve and muscle invasion) Neurotoxicity of drug treatment Polyneuropathies: infammatory, immune mediated, treatment related Syphilitic radiculopathy Treatment related: polyneuropathy/myopathy Zidovudine Acute necrotizing myopathy and myoglobinuria Alcohol Chronic proximal weakness Compartment syndromes (prolonged compression) CN: recurrent nerve Hypokalemic paralysis Mononeuropathy—radial nerve (compression) Myoglobinuria Myopathy Optic nerve (methanol and adultered alcohol) Polyneuropathy (distal, rarely proximal, rarely ulcers) Small fber neuropathy Periodic paralysis Aldosteronism Tetanic muscles Amyloidoma (trigeminal root) Amyloid Autonomic involvement Chronic infammatory diseases, rheumatoid diseases, osteomyelitis CN: V, VII, and other CN Deposition of acute phase plasma protein, serum amyloid A Deposition of immunoglobulin light chains in tissue Familial amyloid polyneuropathies Gelsolin type Mononeuropathy: Carpal tunnel syndrome Muscle amyloid—“muscle amyloidosis” Painful neuropathy Polyneuropathy, painful, hearing loss Primary amyloidosis (AL) Secondary or reactive amyloidosis (AA) Sensorimotor neuropathy Transthyretin Cobalamin defciency, vitamin B12 polyneuropathy Anemia Lead poisoning polyneuropathy Pure red cell anemia: autoimmune disease associated with myasthenia gravis Thalassemia: muscle cramps, myalgia, muscle atrophy © Springer Nature Switzerland AG 2021 331 E. L. Feldman et al., Atlas of Neuromuscular Diseases, https://doi.org/10.1007/978-3-030-63449-0 332 General Disease Finder Addison’s disease: Cushing’s disease: steroid myopathy, general muscle weakness Adrenal dysfunction Cardiac bypass operations: nerve stretch, hypothermia, phrenic nerve lesions Anesthesia Local: drug toxicity, local hematoma, vasoconstriction, needle injury, infection, extravasation Lower extremity (30%): mononeuropathies of peroneal, sciatic, or femoral nerves Malignant hyperthermia Malpositioning Neuromuscular transmission disorders induced by muscle relaxants Regional: Epidural or spinal anesthesia may cause cauda equina lesions Tourniquet palsy Upper extremity (70%): mononeuropathies of brachial, radial, ulnar, or median nerves Brachial artery: median nerve Angiography Cerebral angiography: femoral nerve lesions Femoral nerve lesion in inguinal arterial puncture or hematoma Peripheral: Axillary or femoral artery puncture (brachial plexus and femoral nerve) Acute intensive care myopathy Asthma Eosinophilic syndrome Mononeuropathies Myopathy steroids Demyelinating polyneuropathy Biliary cirrhosis Sensory polyneuropathy Autoimmune adverse events Bone marrow transplant CIDP Focal damage; sacral plexus Infammatory myopathies MG Polyneuropathy Facial nerve lower branch Carotid surgery Horner syndrome Hypoglossal nerve Vagal recurrent nerve Antineoplastic treatment-­associated polyneuropathy: Cancer Acute neurotoxicity; oxaliplatin Cumulative toxicity Bortezomibe Epithelons Platinum derivatives (Cisplatinum Carboplatin, Oxaliplatin) Suramin Taxanes Thalidomide Vinca alkaloids Car T cell therapy CN: optic nerve CN: meningeal carcinomatosis, base of the skull metastasis, nerve infltrations, radiation injury Immune checkpoint inhibitors Immune therapies Induction or reactivation MG (ICI) Malignant peripheral nerve sheath tumors (MPNST) Mantle feld radiation Mononeuropathies (pressure, toxic, extravasation, following operations), rarely infltration or metastasis. CTS in paraproteinemia and amyloidosis Myopathies: cachexia, dermatomyositis/polymyositis, ICI myositis, necrotizing myopathy, neuromyotonia, amyloid deposition, sarcopenia, type 2 fber atrophy, lymphoid infltration, rarely muscle metastasis Neuromuscular transmission: MG and thymoma, LEMS and (lung) cancer Plexopathies (brachial, lumbar, sacral). Polyneuropathies: treatment related (CIPN), rarely autoimmune, paraneoplastic, rarely infltrative Radiation: Early, delayed, and late effects Radiation fbrosis syndrome Radiculopathies (meningeal carcinomatosis, compression or infltration of roots, multiple spinal metastasis), cauda equina syndrome Steroid myopathy Targeted therapies General Disease Finder 333 Addison’s disease: Cushing’s disease: steroid myopathy, general muscle weakness Adrenal dysfunction Carotid surgery—see temporary aortic occlusion (surgery) Circulatory disorders CN: recurrent laryngeal nerve palsy Drug treatment: cholesterol lowering drugs Embolism-compartment syndrome Intermittent claudication Ischemic neuropathy, angiopathic neuropathies Mononeuropathy: femoral nerve lesion (ruptured aneurysm, aortic surgery) Obturator nerve: hematoma in psoas muscle Monomelic neuropathy Muscle hemorrhage: hemophiliacs, anticoagulants: retroperitoneal, buttock, arm, calf Myopathy, cramps and cholesterol-­lowering agents (benzafbrate, clofbrate, fenofbrate, gemfbrozil, lovastatin, nicotinic acid, pravastatin simvastatin) Nerve compression by hematoma (femoral nerve, lumbar plexus, sciatic nerve) Neuropathy by fstula—hemodialysis and mononeuropathies Radiculopathies: compression of L4, 5 and S1, 2 by terminal aorta Ischemic monomelic: predominately sensory with causalgia like pain Venous occlusion—phlegmasia cerulea dolens Compartment syndromes Coma Cranial nerve lesions Critical illness myopathies Critical illness neuropathy Mononeuropathies (malpositioning, pressure palsy) Rhabdomyolysis Steroid myopathy Thick flament myopathy Drug-induced myopathy: acute hypokalemic paralysis, necrotizing myopathy, subacute and chronic Complications of medical and surgical myopathies, ischemic injury during surgery treatment Hip and joint surgery: sciatic, femoral nerve lesions Hypothermia: polyneuropathy Injection into nerves Intramuscular injections Knee surgery: peroneal nerve, ramus infrapatellaris, and cutaneous nerves Mononeuropathies Mononeuropathies due to body position: plexus, radial, ulnar, median, peroneal, femoral nerve lesions Muscle Nerve blockade Neuromuscular blocking agents Neuromuscular transmission: drug-induced MG Postoperative apnea, malignant hyperthermia Postoperatively: GBS Radiation Shoulder surgery Spinal anesthesia: adhesive arachnoiditis, abscess, epidural hemorrhage, nerve roots, paraplegia, sensory loss Spinal cord and nerve plexus (brachial, lumbar, and sacral plexus) mononeuropathies Surgical trauma: mastectomy, median sternotomy, neck surgery (thoracodorsal, long thoracic, axillary nerve), obturator, pelvic surgery (femoral, ilioinguinal, iliohypogastric sciatic, nerve) Tourniquet paralysis Abdominal weakness Diabetes mellitus Autonomic neuropathy Cranial mononeuropathies Mononeuropathies Muscle infarction Plexopathy (lumbar) Polyneuropathy; several distinct types Thoracic (truncal) radicular lesions Alcohol neuropathy Drugs and addiction Cocaine: rhabdomyolysis Compartment syndromes Glue sniffng neuropathy Heroin: nerve compression (coma), trauma from injection, brachial and lumbosacral Nerve compression syndromes Plexopathies Phenylcyclidine: rhabdomyolysis 334 General Disease Finder Addison’s disease: Cushing’s disease: steroid myopathy, general muscle weakness Adrenal dysfunction Hypercalcemia: muscle weakness Electrolyte disorders Hyperkalemia: potassium retaining diuretics Hyperkalemic paralysis Hypermagnesemia muscle weakness Hypernatremia: muscle weakness Hyperphosphatemia Hypocalcemia: tetany Hypokalemic myopathy Hypokalemic paralysis Hypomagnesemia muscle weakness Hyponatriemia: muscle weakness Churg–Strauss syndrome Eosinophilic syndromes Eosinophilia myalgia syndromes Eosinophilic fasciitis Eosinophilic polymyositis Parasitic infections Acute abdomen: porphyria, lead poisoning-polyneuropathy Gastrointestinal disorders Celiac disease: myopathy Chronic diarrhea: malabsorption neuropathies, Whipple’s disease, celiac disease Crohn’s disease: polymyositis Diabetes: autonomic neuropathy Paraneoplastic “intestinal pseudoobstruction” Whipple: macrophagic myofasciitis GBS Hepatic disease Myopathy Hepatitis Neuropathy Panarteritis nodosa (hepatitis B) Polyneuropathy (hepatitis B, C) Primary biliary cirrhosis: polymyositis Amyloidosis Hematologic diseases Anticoagulation Brachial plexus lesions Hematomas in peripheral nerves (femoral nerve, median nerve, obturator nerve, sciatic nerve) Hemophilia: Median nerve—CTS due to hemorrhage Nerve compression (femoral nerve, hemorrhage into iliac muscle) Radial nerve, sciatic nerve, peroneal nerve Ulnar nerve compression Polyneuropathy: Castleman’s syndrome Chemotherapy induced CIDP IgM (MAG) Lymphoma, HIV Macroglobulinemia Neuroleukemiosis Neurolymphomatosis Paraproteinemia POEMS syndrome Waldenstrom’s Thrombocytopenia: Rarely affects peripheral nerves Median nerve mononeuropathy Hyperuricemia Polyneuropathy Radiculopathy General Disease Finder 335 Addison’s disease: Cushing’s disease: steroid myopathy, general muscle weakness Adrenal dysfunction Polyneuropathies: Hypnotic drugs Amitryptiline (rare) Gluthethimide Imipramine Li+ carbonate Metaqualone Perazine Phenelzine Thalidomide and derivatives Infuenza Immunization Macrophagic microfasciitis (hepatitis A, hepatitis B, tetanus) Mumps: sensorineural deafness Polio
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