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Specifics about each Level and each Item:
What you do you need to know:
Level 2
•
Identifies patterns of neuromuscular disease (e.g.,
anterior horn cell disease, nerve root, plexus,
peripheral nerve, neuromuscular junction, muscle)
•
Identifies neuromuscular disorder emergencies
Guillain Barré Syndrome
Myasthenic Crisis
Critical Illness Myopathy and Neuropathy
Botulism
Mononeuropathy Multiplex
Peripheral nerve injury
•
Orders NCS (nerve conductive study)/EMG
(electromyography) testing appropriately
Level 3
•
Diagnoses and manages common neuromuscular disorders
Common
entrapment/compressive neuropathies (carpal tunnel
syndrome, ulnar neuropathy at the elbow, radial
neuropathy across the spiral groove, peroneal neuropathy
at the fibular neck)
Peripheral polyneuropathy
Diabetic polyneuropathy
Guillain-Barré syndrome
Myasthenia Gravis
Amyotrophic lateral sclerosis
Cervical and lumbosacral radiculopathy
Myopathy
Syncope
Orthostatic hypotension
•
Manages neuromuscular disorder emergencies
Guillain Barré Syndrome
Myasthenic Crisis
Critical Illness Myopathy and Neuropathy
Botulism
Mononeuropathy Multiplex
Peripheral nerve injury
•
Interprets results of NCS/EMG testing in context of
clinical presentation
Level 4
•
Diagnoses uncommon neuromuscular disorders
Amyotrophic lateral
sclerosis variants (primary lateral sclerosis,
progressive muscular atrophy, bulbar palsy)
Spinal muscular atrophy (including Kennedy’s disease)
Poliomyelitis and post-poliomyelitis syndrome
Charcot-Marie-Tooth Diseases
Guillain-Barré syndrome variants
Chronic inflammatory demyelinating polyneuropathy and
its variants
Diabetic neuropathies variants (amyotrophy,
mononeuropathies, autonomic)
Dysproteinemic neuropathies
Nutritional and alcoholic neuropathies
Toxic neuropathies
Ischemic/vasculitic neuropathies
Neuropathies of connective tissue disorders
Infectious and granulomatous neuropathies
Lambert-Eaton myasthenic syndrome
Botulism
Congenital myasthenic syndromes
Muscular dystrophies (including Duchenne and Becker,
limb girdle, facioscapulohumeral, myotonic dystrophies)
Metabolic and mitochondrial myopathies
Inflammatory myopathies (Polymyositis/dermatomyositis/necrotizing
immune myopathy/
Inclusion body myositis)
Paraspinous myopathy (Dropped head and bent spine
syndromes)
Endocrine myopathies
Toxic myopathies
Infectious and granulomatous myopathies
Critical illness myopathy and neuropathy
Myotonia Congenita
Periodic Paralysis
Myokymia and neuromyotonia syndromes
Paraneoplastic neuromuscular syndromes
•
Recognizes when tissue biopsy is warranted
Muscle biopsy (muscular
dystrophies, inflammatory myopathies, mitochondrial
myopathies)
Nerve biopsy (mononeuritis multiplex, amyloidosis, and
sarcoidosis)
Skin biopsy (small fiber neuropathy, autonomic
neuropathy)
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Resources for each Level:
Level 2 Resources:
Inpatient
rotations
Introduction and Emergency Neurology lecture series
Neuromuscular grand rounds
Level 3 Resources:
EMG and NCS and
Neuromuscular Lecture Series
NCS Basics
NCS Patterns
Late Responses
Bedside NM Exam
Artifacts
Anomalous Innervations
Repetitive Nerve Stimulation
Nerve Conduction Testing
Needle EMG: Spontaneous Activity
Needle EMG: Spontaneous Activity
Needle EMG: Voluntary Activity
Autonomic Testing
Basic Anatomy and Physiology of Nerve and Muscle
Laboratory Testing NM Diseases
Autonomic Disorders
Spinal Anatomy and Imaging
Basic Anatomy and NCS
UE Neuropathies
LE Neuropathies
Radiculopathy
Carpal tunnel Injection and Tensilon Test
Diabetic Neuropathies
Approach to Peripheral Neuropathy
NMJ Disorders
Muscle & Nerve Biopsy (normal and major abnormal
patterns)
Neuronopathies (Motor and Sensory)
Myopathy (non-inherited)
GBS and CIDP
Gait and Voice disorders in NM Disease
Myotonic Disorders
Small fiber neuropathies
Inherited Muscle Disease
Neuromuscular Grand Rounds
Outpatient clinics
Self-reading
Level 4 Resources
Neuromuscular Grand Rounds
Inpatient Genral service
Outpatient clinics
Self-reading
References
Chapters
Preston DC, Shapiro B,
Proximal, Distal and Generalized Weakness, in Daroff RB,
Fenichel GM, Jankovic J, Maziotta J (eds). Neurology
in Clinical Practice. Sixth edition. Philadelphia,
Elsevier/Saunders, 2012.
Wang LH, Pestronk A,
Muscle pain and Cramps, in Daroff RB, Fenichel GM,
Jankovic J, Maziotta J (eds). Neurology in Clinical
Practice. Sixth edition. Philadelphia,
Elsevier/Saunders, 2012.
Katirji B, Koontz D.
Peripheral Neuropathy, in Daroff RB, Fenichel GM,
Jankovic J, Maziotta J (eds). Neurology in Clinical
Practice. Sixth edition. Philadelphia,
Elsevier/Saunders, 2012.
Meriggolli MN, Sanders DB.
Disorders of Neuromuscular Junction, in Daroff RB,
Fenichel GM, Jankovic J, Maziotta J (eds). Neurology
in Clinical Practice. Sixth edition. Philadelphia,
Elsevier/Saunders, 2012.
Amato AA, Brooks MH.
Disorders of Skeletal Muscle, in Daroff RB, Fenichel GM,
Jankovic J, Maziotta J (eds). Neurology in Clinical
Practice. Sixth edition. Philadelphia,
Elsevier/Saunders, 2012.
Chelimsky T, Robertson D,
Chelimsky G. Disorders of The Autonomic Nervous System,
in Daroff RB, Fenichel GM, Jankovic J, Maziotta J (eds).
Neurology in Clinical Practice. Sixth edition.
Philadelphia, Elsevier/Saunders, 2012.
Books
Katirji B, Kaminski HJ,
Ruff RL (eds). Neuromuscular disorders in Clinical
Practice. Second edition. Springer, New York, 2014.
Preston DC, Shapiro B.
Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic
Correlations. Third edition. Elsevier/Saunders, New
York, 2013. |
