Remote weakenss after botox therapy

Richardson and Beckerly (Muscle and Nerve, 2008) described a patient who received repeated botox A for spasticity post stroke who developed contralateral shoulder weakness with decrement seen on repetitive nerve stimulation, suggestive of neuromuscular blockade.

Spurling's maneuver, in cervical radiculopathy

SM produces Spurling's sign. Method-- rotate head and flex neck towards affected limb then axially compress the head. Production of radicular pain or numbness is called SS, suggests active radiculopathy. Author Wieting et al. modified procedure by extending neck, rotating, then flexing and axially compressing towards affected side in 363 patients. EMG was done immediately after. Modified SM was more sensitive for radiculopathy then traditional SM. Prediction of radiculopathy increased from 17 to 55 % . (Muscle and Nerve 2008).

Alternative to tongue EMG in ALS

Sonoo et al. studied 100 ALS patients. Tongue EMG is sensitive when patients can relax for examination, but only about half or less can. Fibs , positive waves and fasciuclations were seen in 62 % of trapezii, 17 % of sternocleidomastoid muscles, and 8 % of tongue, whereas the number was zero abnormal muscles in cervical spondyslosis patients.

Nerve conductions in POEMS synrdome

Presentation is symmetric peripheral neuropathy resembling CIDP, with areflexia and mixed demyelinating.axonal features. The systemic features include organomegaly, endocrinopathy, monoclonal serum protein ( M protein), and dermatologic abnormalities In a study of 138 patients with POEMS seen over 47 years, Mauermann et al found slowed motor and sensory velocity, prolonged distal latiencues and F waves. However, unlike CIDP there was rarely temporal dispersion or conduction block.