Difference between revisions of "Neuromuscular pathology"

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→‎General: structure
(→‎General: structure)
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** Formalin -> for IHC.
** Formalin -> for IHC.
** 4% Glutaraldehyde fixed -> for electron microscopy.
** 4% Glutaraldehyde fixed -> for electron microscopy.
====Skin biopsies====
* Punch biopsies (3mm) for small fiber neuropathy.
** Paraformaldehyde-lysine-periodate -> for PGP9.5 immunofluorescence.


=Muscle structure/histology=
=Muscle structure/histology=
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Parasitic disease classically associated with consumption of uncooked pork.
Parasitic disease classically associated with consumption of uncooked pork.


=Nerve stuff=
=Nerve stuff=
=Nerve stuff=
===General===
===General===
*Most common biopsy: sural nerve.
*Most common biopsy: sural nerve.
**Approx. 20-30% of the biopsies are diagnostic or may alter treatment decisions.
** Far less common: Superficial peroneal nerve.
*Metabolic, toxic and nutritional causes account for 50% of neuropathies.
*Inflammatory neuropathies (mostly GBS, CIDP or vasculitis): 10-20%.
*Familial neuropathy: 10-20%.
*Neoplasm-associated neuropathy: 5-10%.
===Nerve structure===
*Nerve (surrounded by epineurium).
*Fascicle (surrounded by perineurium).
** Usu 6-15 fascicles in sural nerve.
*Nerve fibre (surrounded by endoneurium).
Epineurium:
** Capillaries, arterioles and venules.
** Fibroblasts, mast cells.
** Pacinian corpuscles (no pathological relevance).
Perineurium:
** Fascicles may separated by perineurial septae.
** Occasional perineurial calcifications (no pathological relevance).


===Stains===
===Stains===
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*[[Leprosy]] (Leprous neuropathy).
*[[Leprosy]] (Leprous neuropathy).
*[[Sarcoidosis]].
*[[Sarcoidosis]].
*Neuropathy with macrophage-induced demyelination (CIDP, GBS).
**Guillain–Barré syndrome.
**Chronic inflammatory demyelinating polyneuropathy (CIDP).<ref>URL: [http://path.upmc.edu/cases/case426.html http://path.upmc.edu/cases/case426.html]. Accessed on: 14 November 2010.</ref>
*CMV neuritis in immuncompromised patients.
*[[Vasculitis]].


<gallery>
<gallery>
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===Other Diseases===
===Other Diseases===
*Guillain–Barré syndrome.
*Chronic inflammatory demyelinating polyneuropathy (CIDP).<ref>URL: [http://path.upmc.edu/cases/case426.html http://path.upmc.edu/cases/case426.html]. Accessed on: 14 November 2010.</ref>
**Essentially chronic Guillain–Barré syndrome.
*Toxic polyneuropathy (drug toxicity).<ref>URL: [http://path.upmc.edu/cases/case173.html http://path.upmc.edu/cases/case173.html]. Accessed on: 8 January 2012.</ref>
*Toxic polyneuropathy (drug toxicity).<ref>URL: [http://path.upmc.edu/cases/case173.html http://path.upmc.edu/cases/case173.html]. Accessed on: 8 January 2012.</ref>


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