Neuromuscular Junction Disorders: Summary

00:01 So in summary, when we think about junctional problems, we're going to know of certain conditions.

00:06 Myasthenia Gravis, Botulism, Lambert-Eaton myasthenic syndrome are the three most important junctional disorders to understand.

00:14 And we're going to review each of those in a subsequent lecture.

00:17 We're going to think of important electrolytes or drugs, heritable, myasthenic syndrome, and some antibiotics that can also affect this area.

00:26 When we're evaluating patients, and worrying about those diagnoses, we want to focus on three things: What is the distribution, sensory findings, and reflex exam for this patient? Neuromuscular junction disorders present with weakness.

00:39 And the weakness can be anywhere in the body, but should include bulbar fibers.

00:43 We should see ptosis, diplopia, dysarthria, and dysphagia.

00:47 The sensory findings are normal.

00:49 The reflex exam is also normal to maybe decreased.

00:52 And we're looking for that important wildcard.

00:54 Presence of fatigable weakness.

00:56 If it's not there, that doesn't mean it's not a neuromuscular junction condition.

01:00 But if we hear fatigability, this should tip us off that this problem may be from the junction.

01:06 And we're going to learn how to use other tests to evaluate patients that are presenting with this type of problem.

01:12 We're going to learn about electrophysiology, both the nerve conduction study, and EMG are important test to figure out where this problem is.

01:19 To exclude muscle and nerve problems, and focus on the neuromuscular junction with repetitive stimulation.

01:26 We're going to learn about important tests, laboratory studies that can also help to evaluate these patients including the acetylcholine receptor antibody, MuSK antibody, and Voltage-Gated Calcium Channel antibodies that you see here.