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Electrical inexcitability of nerves and muscles in severe infantile spinal muscular atrophy
  1. ALICE A KUO
  1. Department of Pediatrics
  2. Division of Neurophysiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
  1. Dr Cameron R Adams, Department of Neurophysiology, Cedars-Sinai Medical Center, 8631 West Third Street, Room 1145, East Tower, Los Angeles, CA 90048, USA.
  1. STEFAN-M PULST,
  2. DAWN S ELIASHIV,
  3. CAMERON R ADAMS
  1. Department of Pediatrics
  2. Division of Neurophysiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
  1. Dr Cameron R Adams, Department of Neurophysiology, Cedars-Sinai Medical Center, 8631 West Third Street, Room 1145, East Tower, Los Angeles, CA 90048, USA.

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Spinal muscular atrophy (SMA) is one of the most common fatal autosomal recessive disorders, characterised by progressive degeneration of anterior horn cells. Before the advent of genetic testing, the diagnosis of SMA was based on clinical, histopathological, and electrophysiological features. In 1992, the International SMA Consortium defined diagnostic criteria of proximal SMA based on clinical findings.1 In SMA type I (severe; Werdnig-Hoffmann disease), affected persons have onset of symptoms before 6 months of age and are never able to sit without support. Electromyography demonstrates denervation features. In early 1995, the candidate gene, the survival motor neuron (SMN) gene, was identified, making the confirmation of SMA by DNA analysis possible.2

With the availability of a genetic test for SMA, many investigators are refining the diagnostic criteria published by the Consortium. Studies involving hundreds of patients with proximal SMA have disclosed a subset of patients who fulfill at least one exclusion criterion defined by the Consortium.3 We identified an infant with severe SMA who fulfilled two exclusion criteria and also showed inexcitability of all nerves as well as muscles. This report will further delineate the wide range of …

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