E-Pearl of the Week
Brought to you by the Resident and Fellow Section of Neurology.
November 20, 2009
Neuromuscular disorders unmasked by statin therapy
Rarely, previously asymptomatic neuromuscular disease may be unmasked by therapy with statins. Case reports have described patients suffering typical muscular symptoms or elevated creatine kinase levels that persist after discontinuation of statins. Underlying diseases identified have included metabolic myopathies such as acid maltase deficiency, McArdle disease, and mitochondrial myopathy. Other more surprising conditions include myotonic dystrophy and Kennedy disease.
Failure of symptomatic improvement or persistent creatine kinase elevation following cessation of statin therapy should prompt the clinician to consider an evaluation for latent neuromuscular disease.
Reference:
Tsivgoulis G, Spengos K, Karandreas N, Panas M, Kladi A, Manta P. Presymptomatic Neuromuscular Disorders Disclosed Following Statin Treatment. Arch Intern Med 2006;166:1519-1524.
Submitted by Ryan Overman, M.D.
Disclosures:
Dr. Overman is a member of the Resident & Fellow Team and Podcast Committee for the Neurology Journal.
For more clinical pearls and other articles of interest to neurology trainees, visit the Resident and Fellow Pages.
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Past E-Pearls
- Isolated medial rectus palsy in midbrain infarction (November 10, 2009)
- Don't get caught with a "bovine arch" (November 04, 2009)
- Cervical MRI with anterior flexion in juvenile distal segmental muscular atrophy (October 28, 2009)
- Paraspinal myotonic discharges in acid maltase deficiency (October 12, 2009)
- Capgras syndrome (September 30, 2009)
- Mirror Movements (September 23, 2009)
- Commonly encountered limitations to nerve conduction studies: (August 12, 2009)
- EEG findings in Moyamoya disease (August 05, 2009)
- Provocation of symptoms in Moyamoya disease (July 29, 2009)
- Thoracic outlet syndrome and retrograde cerebral embolism (July 22, 2009)
- HTLV-1 and tropical spastic paraparesis (July 14, 2009)
- Applause sign (July 09, 2009)
- Headache in ischemic stroke (July 01, 2009)
Visit the E-Pearls Archive (June 2008–June 2009).