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George E. Carvell, PhD, PT   University of Pittsburgh
 
PERIPHERAL NERVE DYSFUNCTION I: NERVE & MUSCLE LESIONS
Ben.  fig 13-30 p 420
Peripheral neuromuscular disorders may arise due to lesions anywhere from the ventral horn to the muscle. Clinicians look for tell-tale patterns of weakness. The neurologist employs the clinical neurological exam, electrophysiological tests (NCV & EMG), muscle biopsy, and laboratory blood values to make a diagnosis. There are characteristic features of lower motor neuron (LMN) disorders, & neuropathic lesions (peripheral nerve) that differ from those of neuromuscular junction disorders or myopathic disease. All have weakness as a common hallmark with variations that tend to localize the lesion. Prognosis & response to treatment varies.
Ben.  fig 13-31  p 421
Normal
Denervated
Myopathic
Myopathy: central nuclei, random large & small fibers, degenerating & splitting fibers and increased connective tissue
Neuropathy: groups of atrophic fibers, and increased connective tissue where axons have degenerated.
Ben.  fig 13-28 p 418
Ben.  fig 13-27 p 418
Ben.  fig 13-14 p 403