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Neuromuscular pathology (view source)
Revision as of 14:22, 8 December 2015
, 14:22, 8 December 2015→Work-up: biopsy
Jensflorian (talk | contribs) (→Central core myopathy: added) |
Jensflorian (talk | contribs) (→Work-up: biopsy) |
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#Laboratory studies, e.g. CK. | #Laboratory studies, e.g. CK. | ||
#Nerve conduction and electromyography studies. | #Nerve conduction and electromyography studies. | ||
#Muscle biopsy. | #Muscle / nerve biopsy. | ||
===Clinical=== | ===Clinical=== | ||
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**Men: 24-195 unit/litre. | **Men: 24-195 unit/litre. | ||
**Women: 24-170 units/litre. | **Women: 24-170 units/litre. | ||
===Biopsy=== | |||
====Muscle biopsies==== | |||
Indications: | |||
* Weakness, Fatigue, Cramps | |||
* Myopathic EMG | |||
* Elevated CK | |||
Not indicated: Myasthenia gravis, myotonia | |||
* MRI to select ideal spots for biopsy. | |||
* In chronic diseases, select a '''moderately''' affected muscle. | |||
** Best specific muscles: Deltoid, Biceps, Quadriceps. | |||
** Avoid areas with previous EMG analysis. | |||
* Tissue should be sent fresh or frozen for analysis. | |||
** Freeze most tissue in isopentane (-160°C) immersed in liquid nitrogen. | |||
** Ultrastructural analyis might be required in some cases -> save something in 4% glutaraldehyde. | |||
* FFPE specimen unsuitable for enzymatic stains. | |||
** Useful for morphology of inflammatory cells. | |||
====Nerve biopsies==== | |||
* Nerve procession: 3 pieces | |||
** Frozen -> useful for acid phosphatase, congo etc.. | |||
** Formalin -> for IHC. | |||
** 4% Glutaraldehyde fixed -> for electron microscopy. | |||
=Muscle structure/histology= | =Muscle structure/histology= | ||