TY  - CHAP
M1  - Book, Section
TI  - Neuromuscular Diseases
A1  - Frontera, Jennifer
A2  - Lee, Kiwon
PY  - 2012
T2  - The NeuroICU Book
AB  - A  26-year-old  woman  with  no  past  medical  history  presents  to  the  emergency  department  (ED)  with  several  days  of  fatigue,  difficulty  climbing  stairs,  and  double  vision.  She  has  one-word  dyspnea  and  appears  to  be  using  accessory  muscles  of  respiration.  Her  chest  radiograph  is  normal  as  are  all  her  initial  laboratory  studies.  She  mentions  having  an  upper  respiratory  infection  1  week  ago.  She  does  not  take  any  medications  and  does  not  have  any  recent  travel.  Vital  signs:  HR  105  bpm,  sinus  tachycardia,  BP  145/90  mm  Hg,  RR  30  breaths/min,  temperature  37.2°C.  Examination:  The  patient  is  in  moderate  respiratory  distress  and  using  accessory  muscles  of  respiration.  She  has  no  rashes.  She  is  drooling  and  has  difficulty  clearing  her  secretions.  Her  oropharynx  is  clear.  Her  neurologic  examination  is  notable  for  ptosis,  bilateral  sixth  nerve  palsy,  bilateral  facial  weakness,  neck  flexion  3/5,  deltoids  3/5,  biceps  3/5,  triceps  3/5,  wrist  extensors  and  intrinsic  hand  muscles  5/5,  iliopsoas  4+/5,  quadriceps  4+/5,  hamstrings  5/5,  tibialis  anterior  5/5,  gastrocnemius  5/5.  Her  sensory  examination  is  normal  as  are  her  reflexes.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - neurology.mhmedical.com/content.aspx?aid=1101642724
ER  -