Cervical Myelopathy Caused by Injections into the Neck.

Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck.

Sarcoid polyneuropathy masquerading as chronic inflammatory demyelinating polyneuropathy.

Introduction: Sarcoid polyneuropathy is a rare and clinically heterogeneous disorder that may be the initial presentation of sarcoidosis.

Methods: We report the clinical, electrophysiological, and pathological findings of a patient who carried a diagnosis of sensory-predominant chronic inflammatory demyelinating polyneuropathy (CIDP) for over a decade but was ultimately found to have sarcoid polyneuropathy.

Results: A 36-year-old man presented with a several-week history of gait difficulty and muscle cramps.

Amyloid polyneuropathy caused by wild-type transthyretin.

Introduction: Amyloidosis derived from transthyretin (TTR) molecules is typically caused by mutations of the TTR gene.

Methods: We describe an elderly patient with a severe length-dependent polyneuropathy that unexpectedly proved to be caused by wild-type transthyretin amyloidosis.

Results: The diagnosis was made by muscle biopsy, because no amyloid deposits were found in the biopsied nerve segment.

Focal amyotrophy in multiple sclerosis.

Introduction: The assumption that multiple sclerosis (MS) is purely a white matter disease has been challenged in recent years by observations of axonal damage and neuronal loss in gray matter of the cortex, subcortex, and spinal cord.

Methods: We report the case of a 71-year-old man with primary progressive MS and longstanding right arm weakness who presented with intermittent right arm pain.

Results: Neurological examination showed atrophy, weakness, and hyporeflexia, and electromyography (EMG) showed acute and chronic partial denervation in multiple segments of the right arm.

Muscle-specific kinase antibodies: a novel cause of peripheral nerve hyperexcitability?

Introduction: Antibodies that target the postsynaptic neuromuscular junction (NMJ) protein, muscle-specific kinase (MuSK), have been associated with myasthenia gravis (MG), often with cramps and fasciculations, after administration of acetylcholinesterase inhibitors (AChE-I).

Methods: In this report, 2 patients are described with elevated MuSK antibodies and evidence of peripheral nerve hyperexcitability (PNH) unrelated to AChE-I medication.

Results: Patient 1 presented with facial neuromyotonia and fasciculations, without overt weakness.