Author Archive | Ronald Fudala

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Surfer’s Myelopathy

Key Points:   Surfer’s myelopathy is a rare, acute, atraumatic myelopathy that occurs in novice surfers. Afflicted individuals are often thin, have poorly developed back musculature, but are otherwise healthy. Symptoms typically start with mild or intense back pain, rapidly progressing to complete or incomplete myelopathy. Clinical and imaging findings have suggested a vascular etiology...

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Statin Myopathy: Recognizing a Unique Phenotype

Introduction: Most cases of muscle symptoms associated with statin use are a direct (toxic) effect of the statin on muscle tissue, typically begin in proximity to the initiation of statin therapy, and resolve after the statin is discontinued. Statin-associated autoimmune necrotizing myopathy (S-ANM), an immune-mediated disease is a relative new comer to the range of...

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Ulnar Neuropathy: Localization Corresponds to Etiology and Pathology

Key Points: Occupation and age may be predictive of the location and extent of pathology seen in Ulnar neuropathies. Ulnar neuropathies found in the dominant arm are more commonly axonal, localized to the humero-ulnar aponeurotic arcade, and associated with repetitive or forceful manual activities. Those in the non-dominant arm are more typically demyelinating, localized to...

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Ultrasound and Multi-Focal Motor Neuropathy

Key Points: Multi-Focal Motor Neuropathy (MMN) is a condition warranting consideration in patients suffering from progressive muscle weakness.  Delays in diagnosis often occur because of unfamiliarity with the disorder, its ability to mimic other diseases causing weakness, and the lack of consistent clinical, laboratory, and electrodiagnostic findings. Recent studies have shown how nerve ultrasound, a...

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Practical Approach to EDX of Carpal Tunnel

Clinical Relevance:  Entrapment of the Median nerve at the wrist (Carpal Tunnel Syndrome) is the most common reason for electrodiagnostic referral.  Despite this, the diagnosis of Carpal Tunnel Syndrome remains challenging due to the large number of electrodiagnostic test methods that have been developed. This situation creates a dilemma for both referring and testing physicians....

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Incidental Pediatric MRI Findings Present Challeges

With increasing use of sophisticated brain and spinal imaging, more children are being referred to pediatric neurosurgeons for unexpected findings on MRI. A report, recently published in the April 2015 issue of Pediatrics discussed the incidence of such findings and the challenges this presents for clinicians. The most common incidental findings referred for neurosurgical input...

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CTE

Imaging May Predict CTE

A recent UCLA study, appearing in the April 6 online edition of the Proceedings of the National Academy of Science, has taken a step towards earlier detection of Chronic Traumatic Encephalopathy. Although there is no definitive diagnosis test for CTE in living individuals, this new work has shown how a Tau-sensitive brain imaging agent (F-18)FDDNP,...

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Treatment-Induced Neuropathy of Diabetes

Insulin Neuritis, recently renamed Treatment-Induced Neuropathy of Diabetes, (TIND) is a length dependent neuropathy characterized by pain and autonomic failure developing in association with treatment resulting in the rapid reduction of blood sugar levels.  It is likely the least known kindred within the family of diabetic neuropathies which include increased susceptibility to focal mononeuropathies, mononeuropathy...

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Dorsal Ramus Diagram

The Dorsal Ramus and Back Pain

Chiropractic Neurologists may be tasked with diagnosing and treating pain that has been recalcitrant to prior forms of intervention.  Overlooking involvement of the lumbar dorsal ramus, and in particular it’s lateral branch, could lead to such a situation.  This article by Zhou et al (found HERE) provides an excellent review of the anatomy, clinical syndromes...

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