| UMN and LMN Disease | Test | Disease | Test |
| Cervical and Lumbar spinal stenosis | *MRI C and T spine | Paraneoplastic?? (not conclusive link in literature) Lymphoma, Lung | *CBC, SPEP *CXR |
| Mitochondrial cytopathy (case) | *lactate *FIT *Bx/genetics | Copper deficiency (case series) | Serum copper, ceruloplasmin, zinc |
| HSP (Complicated) – LL predominance, possible pes cavus, often younger onset | *Genetic testing AD: spastin AR:spatacsin | Adult Polyglucosan Body Disease -S-M PN, neuro bladder, dementia AR: Ashkenazi, German, Italian | *nerve biopsy *axillary skin Biopsy *Brain MRI – WMDz |
| Post Electrocution | *History | Adult Onset Hexosaminidase Def (UMN&LMN, parkinsonism, CB, psychosis, dementia – or combination thereof) | *Hexosaminidase A activity – serum, leucocyte, fibroblast, genetics |
| Adreno-myeloneuropathy (VLCFA) -onset teens -30’s in males -onset age 20 -55 in females | *VLCFA *EDx | HIV (case reports) | HIV |
| LMN Disease | Test | Disease | Test |
| Multifocal Motor Neuropathy | *antiGM1 antibodies *EDx: CB, demyelination *MRI plexus *Ultrasound | Benign Fasciculation Syndrome | *clinical, normal EDX |
| SpinoBulbar Muscular Atrophy (SBMA) -Kennedy’s Disease | *genetics | *Inclusion Body Myositis | CK, muscle Bx |
| Radiation induced LMN (plexus or cord) | *history -years – decades delay | Hereditary Motor Neuropathy (dHMN = distal) *beware motor predominant CMT | *genetics (mostly H&P) |
| Monomelic Amyotrophy Hirayama, AKA juvenile muscular atrophy (ASIA, upper limb) | *MRI -increased posterior epidural space (flexion/extension views) | Adult Onset Hexosaminidase Deficiency (AR) -Psych, cerebellar ataxia | Hexosaminidase A activity – serum, leucocyte, fibroblast, genetics |
| Spinal muscular atrophy type 4 | *genetics (SMN) | Lead Poisoning (UE weakness predominant) | *Pb levels |
| Atypical POEMS pure LMN Pmid 25332554 | SPEP, UPEP | West Nile Virus, Polio | Serology |
| Lyme Disease (mimcs parsonage turner) | Serology | HIV (case reports) | HIV |
| AIP (acute Intermittant porphyria) -abdominal pain(ileus, constipation) -Psych -stuttering motor neuropathy -bathing suit sensory (may be minor) -case report (Albertyn) | Urine: 24h aminolevulinic acid, porphobilinogen Plasma: porphobilinogen deaminase (Tx: IV haem arginate) | ||
| UMN Disease | Test | Disease | Test |
| Hereditary Spastic Paraparesis (HSP) (un)complicated | HTLV-1 Associated Myelopathy (HAM) | Serology | |
| Adreno-myeloneuropathy (VLCFA) -onset teens -30’s in males -onset age 20 -55 in females | *VLCFA | Lathyrism (associated with chickpea consumption) | |
| Cervical stenosis (myelopathy) – Degenerative, Malignancy | *MRI C spine | Multiple Sclerosis | *MR brain, C & T cord *CSF – oligocloncal bands |
| Syrnigomyelia | *MRI Cspine | Chiari Malformation | *MRI Cspine |
| B12, Copper , vitamin E deficiency | Polyglucosan body if UMN predominates | ||
| HIV (vacuolar myelopathy) | |||
| Bulbar Disease | Test | Disease | Test |
| Myasthenia gravis | *SFEMG, RNS, AChRAb, MuSK | SBMA | *genetics |
| OPMD | *genetics, muscle Bx | Inflammatory myopathy | *Ck, muscle Bx |
| Sarcoid or wegeners Multiple cranial neuropathies | ACE, vasculitic W/U (ESR, ANCA, ANA, CRP) | Brainstem Neoplasm, syringobulbia | *MRI brain & C spine |
| Meningeal based neoplasm | *MRI brain and C Spine | ||
Neuromuscular and Electrodiagnostic Clinic 