Senol Apaydın, MD

GLP-1 drugs may provide benefit for idiopathic intracranial hypertension
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...

Lessons from the Lab - YouTube

AANEM Web Lectures on all things ENMG:

youtube.com/playlist?lis...

Guillain–Barré syndrome - Nature Reviews Disease Primers Guillain–Barré syndrome is an acute immune-mediated polyneuropathy that can occur following infections or other rare triggers. In this Primer, Leonhard and colleagues summarize the epidemiology, mecha...

Great review on everything GBS:

www.nature.com/articles/s41...

The location of a AIN neuropathy in a Parsonage Turner Syndron is usually at the level of the upper arm:

pubmed.ncbi.nlm.nih.gov/29461642/

YouTube video by Neuromuscular ultrasound NL ICCNMI2021 Practical introduction to neuromuscular ultrasound

Trying to get into neuromuscular ultrasound?

Start here with 'the' expert on this field, Nens von Alfen, via YouTube

youtu.be/vQI3oIVrv44?...

Neurology 🖐️

Chronic Immune-Mediated Demyelinating Neuropathies : CONTINUUM: Lifelong Learning in Neurology mics of immune-mediated neuropathies are also discussed. LATEST DEVELOPMENTS The underlying pathophysiology of chronic demyelinating neuropathies is heterogeneous, and components of both humoral an...

4) Continuum I
Issue, 2023
journals.lww.com/continuum/ab...

The Ultrasound pattern sum score - UPSS. A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves - PubMed Using the UPSS and its sub-scores gives a new diagnostic power to the method of the peripheral nerve ultrasound.

3) Neuromuscular Ultrasound in demy. PNP, 2015
pubmed.ncbi.nlm.nih.gov/25691156/

Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy typically characterised by symmetrical involvement, and proximal as well as distal muscle weakness (typical CI...

2) Evergreen paper from 2019:
jnnp.bmj.com/content/90/9...

European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force—Second revision Objective To revise the 2010 consensus guideline on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Methods Seventeen disease experts, a patient representative, and two Cochrane ...

Best ressources on everything #CIDP:

1) EAN Guidelines, 2021
onlinelibrary.wiley.com/doi/full/10....

Back to AIN: Work-up:
1 ENMG
2 Neuromuscular Ultrasound (check for a enlarged nerve)
3 and or MRI

AIN is located in the lower arm, but the pathology is usually a fascicle of the median nerve at the upper arm (check for the lesion with the ultrasound at the upper arm 😉)

So, PA not only as a "Plexusneuritis", can present as a multiplex pattern or mononeuropathy or as pure sensory as well.

Usually affected in the context of a Parsonage Turner (PA):
PA ("Plexusneuritis") commonly at the upper plexus, monophasic, painful onset, later with atrophy (ie scapular winging), motor >>sensory

Most common nerves in PA:
Thoracic longus
Supra-/ Infraspinatus
AIN
PIN

AIN Neuropathy:

AIN: Anterior interosseus nerve (median nerve), pure motor (!) nerve (branching off on the upper part of the lower arm) supplying

1 flexor digitorum profundus II/III (distal finger Flexion)
2 flexor pollicis longus (distal thumb flexion) and
3 pronator quadratus (handpronation)

ENMG work-up:
1 APB motor and sensory plus f-waves
2 ADM motor and sensory plus f-waves (DD PNP)
3 Radial sensory (DD Plexus)
(4 Pronator quadratus motor DD AIN)

If any other median hand muscle is affected?

Flexor digitorum profundus II/III and Flexor pollicis longus are supplied by the AIN (proximal median neuropathy). Not affected in CTS. AIN usually in the context of a Parsonage Turner Syndron. AIN has no sensory branch, thus no sensory impairment.

Motor: Weakness of the LOAF muscle

Lumbricalis
Opponens pollicis
Abductor pollicis brevis (APB)
Flexor pollicis brevis

Usually the APB is tested. No other muscle but the LOAF muscle is involved in CTS.

Preparing for the #ENMG boards 😅

How to work up a hand numbness? Most likely? #CTS.

Typical Symptoms: Pain at night (which can spread up to the upperarm).

Sensory: Dig I -IV (with ulnar split). Thenar is spared. Why? Palmar branch, which supplies the thenar, does not pass the carpal tunnel.

So true! I used to listen in while preparing for the boards 🤓

Stroke Guidelines 2024, Bern
neurologie.insel.ch/fileadmin/Ne...

Neurology Exam Prep Podcast Study materials for in-service and certification examinations in neurology residency.

Neurology Exam Prep Podcast:
www.buzzsprout.com/798455

Highly recommended ressources in the field of neurology, ⭐⭐⭐⭐⭐