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Neurology  (Expert Forum)
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Muscle Biopsy
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Muscle Biopsy

by Scheckel5150, Jan 13, 2005 12:00AM
Greetings...



I'm in the process of being evaluated (@ University of Alabama, Birmingham)for a yet to be identified neuromuscular disorder.  



Thus far, my EMG results have indicated the presence of a neuromuscular disorder.  That being said, I'm scheduled for a muscle biopsy on 18 January 05.  



I'm having the following symptoms:



- consistently mildly elevated CK levels, 500 - 750 range

- hx of Malgnant Hyperthermia (diag via Muscle Biopsy)

- muscle stiffness

- twitching muscles

- cramping (any/all muscle groups, but primarily in lower torso/legs)

- increased sweating

- delayed muscle relaxation

- pharyngeal dysphasia (dx)

- insomnia (avg 4 hours sleep per night, fitful)

- migraines

- I have siblings (and mother) w/ many of similar symptoms; although, I'm the only one to have been diagnosed as MH+.



That being said, my question is regarding the muscle biopsy...



The muscle cramping is pervasive throughout my body...and my thigh muscles seem to be least impacted.  Yet this is the muscle that they've chosen to biopsy.  Should they biopsy a more symptomatic muscle (calf muscle, hamstring (sp?).  Or does muscle selection even matter?



If you have any thoughts regarding diag. (IAW above symptoms), I'd appreciate your thoughts.



In any case, I appreciate your time and the service you provide.  



Sincerely,

Steve

by CCF-Neuro-M.D.-CS, Jan 13, 2005 12:00AM
The choice of muscle to biopsy is based on the physicians clinical examination and is also guided by the EMG exam



The choice of a muscle that is very involved is bad as it may show only scarring, that is why they may have chosen a muscle that is less effected, but that will be more likely to show the underlying pathology.



I cannot make a clinical diagnosis, but your symptoms seem to be localized to muscle, either a myopathy (can be due to genetic, inflammatory, or abnormal metabolism) or problems with the enzymes involved in the functioning of muscle. I'm sure these will all be evaluated at Alabama. One cannot be moe specific than a disorder of muscle without further testing



Good luck
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