Neurology Exam Prep Podcast Episode 76 - Neuromuscular Emergencies
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Oct 27, 2025 William Signorile, a neurology clinician moving on to a fellowship, and Jeff Dewey, a neuromuscular specialist, shed light on critical neuromuscular emergencies. They discuss the diagnostic approach to Guillain-Barré Syndrome, highlighting red flags and essential assessments. The duo contrasts Myasthenia Gravis with LEMS and covers treatments for myasthenic crisis. They also delve into the management of respiratory complications, emphasizing careful monitoring and decision-making in acute care settings.
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GBS Is A Spectrum With Rapid Progression
- Guillain-Barré syndrome (GBS) is a spectrum with AIDP the common form and variants like AMAN, AMSAN, and Miller-Fisher.
- GBS often follows infection or vaccination and can progress to quadriplegia or respiratory failure within weeks.
Use Serial Exams And Timely LP In GBS Workup
- Perform frequent serial neurologic exams including strength and reflex checks in suspected GBS.
- Get lumbar puncture, but expect early CSF protein may be normal; flag >10 WBC as a mimic signal.
Trust ABG And The Exam For Respiratory Risk
- Prioritize ABG and clinical observation over pulse oximetry when assessing respiratory risk.
- Watch for accessory muscle use, speaking effort, and early loss of deep tendon reflexes.