Neuro Session
 Proximal
 Neuromuscular Junction
o Eyes
o Head and neck
Clinical Features
 Anterior Horn Cells (SMA & PMA)
o Bulk
 Where ever it starts it gets atrophic
o Tone
 decreased
o Power
 Decreased
o Reflexes
 Absent/decreased
o Fasciculations
 Present +++
o Sensory
 Normal
 Spinal Nerve (reticulopathy)
o Schwannoma/Neurofibroma
o Bulk
 Decreased or normal in a myotome pattern
 Sensory Loss: mid dermatome
o Tone
 Normal to Decreased
o Power
 Decreased
o Reflexes
 Normal to Decreased
o Fasciculations
 Not present *differentiating factor*
o Sensory
 Normal to Decreased dermatomal pattern
 Brachial Plexus (multiple distribution of nerves)
o Neuralgic Amyotrophy
o Bulk
 Normal to Decreased
o Tone
 Normal to Decreased
o Power
 Normal to Decreased
o Reflexes
 Decreased
o Fasciculations
 None
o Sensory
 Normal to Decreased

 Peripherial Nueropathy
o Charcot Marie tooth disease
o Bulk
 Normal to Decreased
2
o Tone
 Normal to Decreased
o Power
 Normal to Decreased (distal to proximal)
o Reflexes
 Normal to decreased (distal to proximal)
o Fasciculations
 None
o Sensory
 Normal to Decreased
 Neuromuscular Junction
o Myasthenia gravis/Lambert England
o Bulk
 Normal
o Tone
 Normal to Decreased
o Power
 Decreased (outer pharyngeal) – dysphagia
o Reflexes
 Normal to Decreased
o Fasciculations
 None
o Sensory
 Normal
 Muscle
o Dushane Wats
o Bulk
 Normal to Decreased
3
o Tone
 Decreased
o Power
 Decreased (proximal)
o Reflexes
 Normal to Decreased
o Fasciculations
 None
o Sensory
 Normal
 Labs
o EMG: to confirm localization & assess severity
o
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