RT Book, Section A1 Amato, Anthony A. A1 Russell, James A. SR Print(0) ID 1115656168 T1 Approach to Patients with Neuromuscular Disease T2 Neuromuscular Disorders, 2e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071752503 LK neurology.mhmedical.com/content.aspx?aid=1115656168 RD 2024/11/12 AB The evaluation of patients with suspected neurologic disease remains first and foremost a bedside exercise. Accurate diagnosis requires consideration of individual patient and disease differences. Despite the benefits of evidence-based medicine, conclusions are more relevant to populations than to individuals. Confounding variables that are part of the human experience may be overlooked or overemphasized by testing algorithms. This textbook will repeatedly emphasize the strongly held philosophy of its authors, that is, patient management flows from an accurate diagnosis. An accurate diagnosis is most likely to be obtained based on a differential diagnosis driven by clinical assessment and hypotheses. These hypotheses should be formulated on the basis of the principles of neurologic localization, the correlation of the chronologic course of symptom development with the behaviors of differing disease conditions, and the application of risk factor analysis. Ideally, the tests described in the subsequent two chapters and throughout the text would be utilized with the primary intent of resolving a clinically established differential diagnosis ideally to prove a working diagnosis. As all tests are potentially fallible, the credibility of their results diminishes when they are used as screening procedures. A laboratory abnormality, occurring without the context of clinical correlation, fails to establish the desired confidence in a cause and effect relationship with the patient's complaint(s). Metaphorically, laboratory tests are analogous to a carpenter's tools. They are of great value when placed in the hands of a skillful artisan, but are potentially damaging if used injudiciously.