{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:25:21Z","timestamp":1786119921805,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Polyneuropathies may exhibits clinical, electrophysiologic signs of neuromuscular junction impairment. Distal motor nerve terminals and neuromuscular junction contain pre or postsynaptically specific targets for circulating autoantibodies, if present in neuropathies. Motor nerve terminal blockade either reversible or permanent is a putative factor of muscle weakness. A 59-year-old patient exhibited oropharyngeal, facial, extremity weakness, fluctuating fatigability, and areflexia. Elecectrophysiologic studies showed purely motor axonal polyneuropathy. Thenar, facial slow rate repetitive stimulation revealed up to 47% decrement of compound muscle action potential size. Single fiber electromyography on voluntary activation confirmed increased jitter and impulse blocking in all muscles examined in one third of the fibers. Repeated testings for antibodies to gangliosides, acetylcholine, muscle tyrosine kinase receptors, voltage-gated calcium channels were negative. Oral pyridostigmine bromide improved bulbar symptoms. Pulse intravenous immunoglobulin, oral steroids, and azathioprine had steady benefit. Impairment of neuromuscular transmission if occurring in chronic axonal neuropathies highlights mechanisms and significance of neuromuscular chronic \u201csynaptopathies.\u201d<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/cnd.0b013e3181df2b18","type":"journal-article","created":{"date-parts":[[2011,5,21]],"date-time":"2011-05-21T10:07:07Z","timestamp":1305972427000},"page":"223-226","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent Chronic Motor Axonal Polyneuropathy and Synaptic Impairment of Neuromuscular Junction"],"prefix":"10.1097","volume":"12","author":[{"given":"Giuliana","family":"Galassi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Canali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Ariatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Valzania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-3-20240808","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1113\/jphysiol.2009.171702","article-title":"Pathophysiological actions of neuropathy-related anti-ganglioside antibodies at the neuromuscular junction.","volume":"587","author":"Plomp","year":"2009","journal-title":"J Physiol"},{"key":"R2-3-20240808","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1212\/WNL.56.1.67","article-title":"Combined pre and postsynaptic action of IgG antibodies in Miller Fisher syndrome.","volume":"56","author":"Buchwald","year":"2001","journal-title":"Neurology"},{"key":"R3-3-20240808","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s004150050585","article-title":"Validity and reliability of two muscle strength scores commonly used as endpoints in assessing treatments of myasthenia gravis.","volume":"247","author":"Sharshar","year":"2000","journal-title":"J Neurol"},{"key":"R4-3-20240808","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1468-1331.2006.01278.x","article-title":"Report of a joint task force of the European Federation of Neurological Societies and the Peripheral nerve Society.","volume":"13","year":"2006","journal-title":"Eur J Neurol"},{"key":"R5-3-20240808","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1002\/mus.1140","article-title":"Literature review of the usefulness of repetitive nerve stimulation and single fiber EMG in the electrodiagnostic evaluation of patients with suspected myasthenia gravis or Lambert-Eaton myasthenic syndrome.","volume":"24","year":"2001","journal-title":"Muscle Nerve"},{"key":"R6-3-20240808","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1002\/(SICI)1097-4598(199609)19:9<1069::AID-MUS1>3.0.CO;2-Y","article-title":"Single fiber electromyography. 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