A 75 year old male patient has had progressive weakness and and difficulty walking for 4 months, difficulty walking for 4 months, described as “walking like a drunk..”
LL WEAKNESS
localization Journey brain → spine → peripheral nerves → NMJ → muscles What are you looking for in the history ?
SENSORY COMPONENT ?
NMJ VS MUSCLES
Spine vs peripheral nerve
Weakness pattern fluctuating ?
autonomic Bowel /bladder ?
myopathy
NMJ pre vs post synaptic ? w/ activity ? Ocular?
spine / cauda equina
Improving
wosening+ ocular
Presynaptic ;LEMS
Post synaptic ;MG
Let's go back to the story and take a look .....
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