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https://www.readbyqxmd.com/read/27922506/coding-in-muscle-disease
#1
Lyell K Jones, John P Ney
Accurate coding is critically important for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of administrative coding for patients with muscle disease and includes a case-based review of diagnostic and Evaluation and Management (E/M) coding principles in patients with myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922493/the-role-of-electrodiagnostic-testing-imaging-and-muscle-biopsy-in-the-investigation-of-muscle-disease
#2
Laura K Rosow, Anthony A Amato
PURPOSE OF REVIEW: This article reviews the roles of electrodiagnostic testing, imaging studies (MRI and ultrasound), and muscle biopsy in evaluating patients for possible muscle diseases. RECENT FINDINGS: In addition to electrodiagnostic testing and muscle biopsy, muscle imaging is increasingly being used in the evaluation of patients with suspected muscle disease. MRI and ultrasound can help identify patterns of muscle involvement that may narrow the differential diagnosis and guide further testing...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27902997/chronic-inflammatory-demyelinating-polyradiculoneuropathy-cidp-clinical-features-diagnosis-and-current-treatment-strategies
#3
Jacques Reynolds, George Sachs, Kara Stavros
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits that can lead to significant neurological disability. The diagnosis is based on a combination of clinical examination findings, electrodiagnostic studies, and other supportive evidence. Recognizing CIDP and distinguishing it from other chronic polyneuropathies is important because many patients with CIDP are highly responsive to treatment with immunosuppressive or immunomodulatory therapies...
December 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27902538/ulnar-tunnel-syndrome-radial-tunnel-syndrome-anterior-interosseous-nerve-syndrome-and-pronator-syndrome
#4
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
November 29, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27898216/characterization-of-prostacyclin-associated-leg-pain-in-patients-with-pulmonary-arterial-hypertension
#5
Gabriel L Pagani-Estévez, Keith M Swetz, Michael D McGoon, Robert P Frantz, Susan K Tointon, Ann M Karnyski, Louise A Durst, James C Watson
RATIONALE: Prostacyclin-associated leg pain is a potentially debilitating adverse effect of prostacyclin therapy for patients with pulmonary arterial hypertension (PAH). However, to our knowledge, this entity has not been systematically studied. OBJECTIVE: To characterize the clinical features and metabolic risk factors for prostacyclinassociated leg pain. METHODS: At one academic medical center we assembled and analyzed a case series of patients with PAH and prostacyclin-associated leg pain...
November 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27864983/diagnosis-of-unilateral-trapezius-muscle-palsy-54-cases
#6
Paul Seror, Tanya Stojkovic, Marie Martine Lefevre-Colau, Timothée Lenglet
INTRODUCTION: We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. METHODS: Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. RESULTS: In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n=22), idiopathic unilateral TM palsy (n=5), regional neck radiotherapy for different conditions (n=2), facioscapulohumeral dystrophy (FSH) (n=4), abnormal loop of the jugular vein (n=1), or basilar impression (n=1)...
November 16, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27861224/neuralgic-amyotrophy-associated-with-hepatitis-e-virus-infection-first-case-in-the-united-states
#7
Jose D Avila, David Lacomis, Erek M Lam
Hepatitis E is an emerging viral infection in developed countries. It can present with multiple extra-hepatic manifestations, including neuralgic amyotrophy. We report a 52-year-old man who presented with neck and shoulder pain followed by orthopnea and left arm weakness. Electrodiagnostic testing showed left phrenic neuropathy and denervation in bilateral C5 and C6 myotomes. He also had elevated liver enzymes, which led to the diagnosis of acute hepatitis E. This is the first case of neuralgic amyotrophy associated with hepatitis E in the United States...
December 2016: Journal of Clinical Neuromuscular Disease
https://www.readbyqxmd.com/read/27859377/is-electrodiagnosic-testing-for-polyneuropathy-overutilized
#8
Elliot B Bodofsky, Gregory T Carter, John D England
Distal symmetric polyneuropathy (DSP) is one of the most common problems seen in clinical practice and one of the most frequent reasons for electrodiagnostic (EDX) testing. Most studies have supported the use of EDX testing for patients with suspected DSP. Some recent articles assert that EDX testing has a low yield in suspected DSP and is only needed for atypical presentations (a minority). However, many peer-reviewed articles indicate that EDX frequently changes diagnosis and management, and leads to a better understanding of the underlying pathology, severity, and prognosis...
November 8, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27847721/prevalence-and-related-characteristics-of-carpal-tunnel-syndrome-among-orchardists-in-the-gyeongsangnam-do-region
#9
Ho-Yeon Jung, Min Sik Kong, Seung Hun Lee, Chang Han Lee, Min-Kyun Oh, Eun Shin Lee, Heesuk Shin, Chul Ho Yoon
OBJECTIVE: To determine the prevalence and related characteristics of carpal tunnel syndrome (CTS) in orchardists and to investigate the association between electrodiagnostic severity and physical examinations. METHODS: Between July 2013 and September 2014, 377 subjects (174 men and 203 women) visited the Gyeongsang National University Hospital's Center for Farmer's Safety and Health. All the subjects underwent electrodiagnostic tests and physical examination, including Phalen's test, Tinel's sign, and Durkan's carpal compression test (CCT)...
October 2016: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27843673/median-and-ulnar-neuropathy-assessment-in-parkinson-s-disease-regarding-symptom-severity-and-asymmetry
#10
Nilgul Yardimci, Ozlem Cemeroglu, Eda Ozturk, Gülsüm Gürlü, Esra Şahin, Saliha Bozkurt, Tugba Cengiz, Gulderen Karali, Hasim Cakirbay, Atilla İlhan
Background. While increasing evidence suggests comorbidity of peripheral neuropathy (PNP) and Parkinson's disease (PD), the pathogenesis of PNP in PD is still a debate. The aim of this article is to search the core PD symptoms such as rigidity and tremor as contributing factors to mononeuropathy development while emphasizing each individual patient's asymmetric symptom severity. Methods. We studied 62 wrists and 62 elbows of 31 patients (mean age 66.48 ± 10.67) and 64 wrists and 64 elbows of 32 age-gender matched healthy controls (mean age 62...
2016: Parkinson's Disease
https://www.readbyqxmd.com/read/27829824/the-prevalence-of-pronator-teres-among-patients-with-carpal-tunnel-syndrome-cross-sectional-study
#11
Mahsa Asheghan, Mohammad Taghi Hollisaz, Abbas Shahabi Aghdam, Amidoddin Khatibiaghda
The aim of conducting this study was to determine the prevalence of PTS among patients with carpal tunnel syndrome. The study was conducted from March 2014 to April 2015 in the EDX ward and clinic of physical medicine and rehabilitation at the university hospital; Baqiytallah, a large referral practice and research center in Tehran. We included patients with clinical symptoms and signs of CTS. Clinical assessments were aimed to the diagnosis of CTS and PTS. At the next stage, ultrasound study was performed for the participants with suspected CTS...
September 2016: International Journal of Biomedical Science: IJBS
https://www.readbyqxmd.com/read/27819421/early-electrodiagnostic-features-of-upper-extremity-sensory-nerves-can-differentiate-axonal-guillain-barr%C3%A3-syndrome-from-acute-inflammatory-demyelinating-polyneuropathy
#12
Yong Seo Koo, Ha Young Shin, Jong Kuk Kim, Tai Seung Nam, Kyong Jin Shin, Jong Seok Bae, Bum Chun Suh, Jeeyoung Oh, Byeol A Yoon, Byung Jo Kim
BACKGROUND AND PURPOSE: Serial nerve conduction studies (NCSs) are recommended for differentiating axonal and demyelinating Guillain-Barré syndrome (GBS), but this approach is not suitable for early diagnoses. This study was designed to identify possible NCS parameters for differentiating GBS subtypes. METHODS: We retrospectively reviewed the medical records of 70 patients with GBS who underwent NCS within 10 days of symptom onset. Patients with axonal GBS and acute inflammatory demyelinating polyneuropathy (AIDP) were selected based on clinical characteristics and serial NCSs...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27819419/clinical-significance-of-repetitive-compound-muscle-action-potentials-in-patients-with-myasthenia-gravis-a-predictor-for-cholinergic-side-effects-of-acetylcholinesterase-inhibitors
#13
Hyo Eun Lee, Yool Hee Kim, Seung Min Kim, Ha Young Shin
BACKGROUND AND PURPOSE: Acetylcholinesterase inhibitors (AChEIs) are widely used to treat myasthenia gravis (MG). Although AChEIs are usually tolerated well, some MG patients suffer from side effects. Furthermore, a small proportion of MG patients show cholinergic hypersensitivity and cannot tolerate AChEIs. Because repetitive compound muscle action potentials (R-CMAPs) are an electrophysiologic feature of cholinergic neuromuscular hyperactivity, we investigated the clinical characteristics of MG patients with R-CMAPs to identify their clinical usefulness in therapeutic decision-making...
October 2016: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/27807187/clinical-spectrum-of-castleman-disease-associated-neuropathy
#14
Elie Naddaf, Angela Dispenzieri, Jay Mandrekar, Michelle L Mauermann
OBJECTIVE: To define the peripheral neuropathy phenotypes associated with Castleman disease. METHODS: We conducted a retrospective chart review for patients with biopsy-proven Castleman disease evaluated between January 2003 and December 2014. Patients with associated peripheral neuropathy were identified and divided into 2 groups: those with Castleman disease without POEMS syndrome (CD-PN) and those with Castleman disease with POEMS syndrome (CD-POEMS). We used a cohort of patients with POEMS as controls...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27801698/magnetic-resonance-neurographic-and-clinical-long-term-results-after-oberlin-s-transfer-for-adult-brachial-plexus-injuries
#15
Florian S Frueh, Michael Ho, Andreas Schiller, Pascal Ducommun, Andrei Manoliu, Gustav Andreisek, Maurizio Calcagni, Pietro Giovanoli
The primary goal of the surgical treatment of upper brachial plexus injuries is to restore active elbow flexion. Accordingly, Oberlin's transfer has been frequently performed since 1994 and has influenced the development of other nerve transfers. However, the window of opportunity for nerve transfers remains a subject of controversy. The objective of this study was to assess magnetic resonance (MR) neurographic, clinical and electrophysiological long-term results after Oberlin's transfer. For this purpose, we performed a retrospective follow-up study...
October 31, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27793469/challenges-in-pediatric-chronic-inflammatory-demyelinating-polyneuropathy
#16
Göknur Haliloğlu, Deniz Yüksel, Cağri Mesut Temoçin, Haluk Topaloğlu
Chronic inflammatory demyelinating neuropathy, a treatable immune-mediated disease of the peripheral nervous system is less common in childhood compared to adults. Despite different sets of diagnostic criteria, lack of a reliable biologic marker leads to challenges in diagnosis, follow-up and treatment. Our first aim was to review clinical presentation, course, response to treatment, and prognosis in our childhood patients. We also aimed to document diagnostic and therapeutic pitfalls and challenges at the bedside...
September 22, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27791975/wide-decompression-may-render-the-ulnar-nerve-unstable-a-cadaveric-study
#17
Andrew P Hurvitz, Brian T Fitzgerald, Leo T Kroonen
The purpose of this study was to evaluate for ulnar nerve instability following incrementally widened in situ decompression. A standard release of the ulnar nerve was performed in 16 cadaveric elbows, extending from 7cm distal to the medial epicondyle, and then released proximally for a total of 10 cm in 2-cm increments. Eight of the 16 elbows (50%) displayed subluxation of the ulnar nerve following complete in situ decompression. The rate of subluxation was found to increase with increasing length of proximal decompression...
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27786371/proper-performance-of-autonomic-function-testing
#18
(no author information available yet)
INTRODUCTION: The aim of this position statement is to provide a recommendation from experts at the AANEM on the proper performance of autonomic testing. METHOD: The AANEM Professional Practice Committee and selected AANEM members reached a consensus based on expert opinion on the training required to perform autonomic testing and the appropriate performance of such tests. RESULTS: Individuals without sufficient medical education in autonomic disorders are unqualified to interpret the data generated or to coordinate the findings with other clinical information in order to reach a clinical diagnosis...
October 27, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27783000/the-influence-of-insurance-type-on-management-of-carpal-tunnel-syndrome-an-analysis-of-nationwide-practice-trends
#19
Erika D Sears, Peter R Swiatek, Hechuan Hou, Kevin C Chung
BACKGROUND: The purpose of this study was to evaluate the impact of insurance type on use of diagnostic testing, treatments, and the efficiency of care for patients with carpal tunnel syndrome. METHODS: The 2009 to 2013 Truven MarketScan Databases were used to identify adult patients with carpal tunnel syndrome. Insurance type was categorized as fee-for-service versus capitated managed care. Multivariable regression models were created to evaluate the relationship between insurance type and costs, number of visits, treatment, and electrodiagnostic study use, and controlling for demographic characteristics and comorbidities...
November 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27763908/ultrasonographic-and-surgical-findings-of-acute-radial-neuropathy-following-blunt-trauma
#20
Seok-Youl Choi, Jong Woong Park, Dong Hwee Kim
Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action...
November 2016: American Journal of Physical Medicine & Rehabilitation
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