Clinical Reasoning: A 60-Year-Old Woman With Rapidly Progressive Muscle Weakness and Ophthalmoparesis.

The clinical assessment of patients with proximal muscle weakness represents a frequent yet intricate challenge. We present the case of a 60-year-old woman who experienced a progressive, symmetrical weakness in proximal limbs and bulbar muscles over 6 months. Notable clinical findings included bilateral ophthalmoparesis; widespread muscle atrophy; and pronounced weakness in craniobulbar, cervical, and proximal muscles, more severe than in distal ones.

A Case of Probable Multifocal Motor Neuropathy With Clinical Stability for Ten Years After a Single Treatment of Rituximab.

Multifocal motor neuropathy is a rare, immune-mediated motor neuropathy with asymmetric, often debilitating progressive weakness. The efficacy of intravenous immunoglobulin in this disease is well established; however, the response typically wanes over time. No other agent has shown similar therapeutic efficacy.

The Role of Imaging for Disorders of Peripheral Nerve.

Peripheral nerve imaging is a helpful and sometimes essential adjunct to clinical history, physical examination, and electrodiagnostic studies. Advances in imaging technology have allowed the visualization of nerve structures and their surrounding tissues. The clinical applications of ultrasound and magnetic resonance imaging (MRI) in the evaluation of peripheral nerve disorders are growing exponentially.

Neuromuscular ultrasound in clinical practice: A review.

Neuromuscular ultrasound (NMUS) is becoming a standard element in the evaluation of peripheral nerve and muscle disease. When obtained simultaneously to electrodiagnostic studies, it provides dynamic, structural information that can refine a diagnosis or identify a structural etiology. NMUS can improve patient care for those with mononeuropathies, polyneuropathy, motor neuron disease and muscle disorders.

Mechanisms of change of traditional mindfulness practice in Thai adolescent students: a cross-sectional mediation study.

Given the substantial evidence for the efficacy of secular mindfulness-based interventions (MBIs) for reducing psychological distress and increasing wellbeing, research attention has more recently turned to investigating the mechanisms by which this is achieved and has revealed that MBI works not only directly on reducing distress, but also indirectly through a reduction in mediating problems such as rumination and emotional regulation difficulty. However, to the best of the authors' knowledge, no studies have yet been undertaken to evaluate the effect on such mediating conditions, of traditional Buddhist mindfulness meditation, as practiced in Eastern cultures and increasingly in the West, from which MBIs have been derived but remain distinctly different. The current study was therefore designed to examine the effect of traditional mindfulness on mediating conditions in participants who were born into and were experienced in this approach.

Myasthenia triggered by immune checkpoint inhibitors: New case and literature review.

Immune checkpoint molecules are potent regulators of immunologic homeostasis that prevent the development of autoimmunity while maintaining self-tolerance. Inhibitors of immune checkpoint molecules are used as immunotherapy in the treatment of melanoma and different types of refractory cancer, and can trigger various autoimmune complications including myositis and myasthenia gravis. We describe a case of generalized myasthenia gravis induced by pembrolizumab and review 11 other cases.