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Ultrasound and Electrodiagnosis at AANEM

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The 2023 American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) Annual Meeting in Phoenix, Arizona, was an excellent opportunity to explore the latest in in diagnosis and treatment of neuromuscular disorders. This year’s meeting focused on the role of a multidisciplinary approach to the rehabilitation of persons with these disorders and cultivating the next generation of neuromuscular specialists. 

AANEM President Bob Irwin, MD, selected Disability and NMDs: The Whole Enchilada as the theme for the conference. I had the pleasure of attending the Role of Rehabilitation Medicine in Neuromuscular Care: The Value of Integrating PM&R into the Care Plan. This session was typical of the meeting where we saw evidence of how rehabilitation paired with advancing technology allows us to deliver some of the best outcomes for our patients. I learned about how remote clinic visits, AI generated counseling, and predictive models could reduce falls and prevent functional decline. Another session led by Eric Morrison and Evan Zeldin drilled down on the role of Lifestyle Medicine in managing neuromuscular conditions such as polyneuropathy and tendonopathy.  Before this presentation, I had never considered the role of epigenetics and the microbiome when thinking about how I can best help my patients with painful neuromuscular and musculoskeletal conditions.

Traditional diagnosis of neuromuscular conditions has hinged on electrodiagnosis which includes nerve conduction studies and needle electromyography. One of the most exciting developments in the field over the past year has been the growth of neuromuscular ultrasound as a modality for diagnosis. Not only does ultrasound improve patient care, but it actually helps us to learn about pathology and revisit “assumptions” about disease that we made about pathology during residency. For example, neuralgic amyotrophy used to be thought of as a brachial plexopathy, but we are now learning that it is more of a multifocal fasiculopathy. This improved understanding has led to breakthroughs in surgical treatment. But the patient care doesn’t stop there. Presenters such as Noriko Anderson shared how we built on these advances in diagnosis with interdisciplinary rehabilitation and patient support resources to provide holistic patient care and achieve the very best possible outcomes.  According to John Melvin, “This represents a longstanding theme in the AANEM. The advances in ultrasound in the 2020s are teaching us about pathology in neuralgic amyotrophy just as the advances in electrodiagnosis changed our thinking about carpal tunnel in the 1960s.”

One of the main thrusts of the of the AANEM annual meeting is to involve the next generation of neuromuscular specialists to serve our patient population on through clinical care, education, scholarship, and advocacy. The Young Leadership Council brought together residents, fellows, and medical students from across the country to help to spark interest in electrodiagnosis, neuromuscular ultrasound, and the treatment of neuromuscular conditions. Their input has helped the AANEM to improve the quality of the educational materials available to support the growth of trainees as they master the medical knowledge and technical skills necessary to care for patients with neuromuscular disorders. Angela Ballesteros, a third year medical student at Texas Tech University Health Sciences Center shared, “I am beyond grateful for the culture and space the AANEM has created for us and I am so grateful for the abundance of presentations, mentorship, career advice, bowties, and most importantly support. The AANEM has shown me the incredible advancements that have been made in NM and EDX medicine, and has shown me the promise of the future – one that I hope to contribute to some day!”

Seeing students like Angela get fired up about neuromuscular medicine and learning about all the advancements and hope for the future always allows me to leave the AANEM Annual Meetings with my cup filled up and this year was no different. I’m already looking forward to the 2024 annual meeting in Savannah, Georgia.

Dr. Norbury has no conflicts of interest to report.

Image by GoodStudio / Shutterstock

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