Teerin Liewluck, MD, FAAN, FANA

Professor of Neurology, Myologist, Myopathologist & Electromyographer at Mayo Clinic; Tweets limited to Medicine, Travel & Food.

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

@MarcusVPinto @aszelikovich @MayoClinic Congratulations, Marcus!!!

[NEJM @NEJM]

Inflammatory myopathies are typically associated with a myositis-specific autoantibody that determines the diagnosis and prognosis. Myositis subgroups have distinct pathomechanisms that now allow for targeted therapies.

Learn more in the Review Article “Inflammatory Myopathies” by Yves Allenbach, MD, PhD, and Olivier Benveniste, MD, PhD: https://t.co/ZeCKdNe87v

[Marcus Pinto, MD, MS @MarcusVPinto]

Hot off the press! Nerve biopsy is more sensitive than fat aspirate and skin biopsy for amyloid diagnosis in symptomatic ATTRv peripheral neuropathy (95% vs 48% and 53%). Great @MayoClinicNeuro enterprise collaboration and strong work from Mayo MS4 and incoming @UVANeurology star resident @APanrudkevich . @GreenJournal https://t.co/689eniGuQh

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

@MarcusVPinto @MayoClinicNeuro @UVANeurology You are such a great mentor!

[Hebatallah Rashed, M.D., PhD @Rashedheba83]

I had so much pleasure to interview Dr. Margherita Milone on this group of genetically determined disorders that may present with the triade of IBM, Paget's disease, and FTD. The phenotype is variable, which makes the diagnosis challenging.
@AANEMorg
https://t.co/NjMpTIMDx1

[Zach London @zach_london]

Newsflash: A randomized controlled trial supports a treatment that millions of patients been using over the last 70+ years!

This could have gone two ways, and speaking on behalf of everyone who cares about MG care, all I can say is... Phew!
https://t.co/VVa3wQcFyy

[Marcus Pinto, MD, MS @MarcusVPinto]

Before you diagnose CIDP:

✅ Make sure to check if the motor conduction velocity is truly in the demyelinating range. Upper limb CV should be slower than 35 m/s and lower limb less than 25 m/s. Be careful with amplitude-dependent slowing.

✅ Consider whether it's a variant — if so, be aware that these cases are more prone to misdiagnosis.

✅ Exercise caution with elevated CSF protein levels, as this finding is non-specific and should not be solely relied upon for diagnosis.

✅ Look for the presence of monoclonal gammopathy, which could indicate POEMS syndrome, AL amyloid, or IgM/Anti-MAG neuropathy.

✅ If any of these are present consider an auto-immune nodopathy: markedly elevated CSF protein (>200 Mg/dl), distal predominant weakness, CNS demyelination, nephrotic syndrome, marked hypertrophy of nerve roots and plexi, respiratory failure, or cranial neuropathy

✅ Finally, verify your diagnosis against the EAN/PNS guidelines to ensure accuracy here: https://t.co/xQI59awxQU

[Latika @LatikaGupta_]

#Myositis mimics are a regular challenge encountered in clinics, and critically important for our patients.
A real pleasure working with #neurology colleagues on this—highlighting practical #guidance that is especially useful for new consultants : https://t.co/9tz8KTwPXa

[Journal of Neuromuscular Diseases @journal_nd]

📄 New review in JND: Somatic instability in DM1

CTG repeat expansions:
• Grow over time
• Vary by tissue (muscle > blood)
• Are shaped by DNA repair (MMR, FAN1)
Read the open access review here: https://t.co/HXzJrMu1ag

#DM1 #RepeatExpansion #Genetics #RareDisease

[Marcus Pinto, MD, MS @MarcusVPinto]

IVIg for CIDP: Start with the loading dose (2 g/kg), then give 1 g/kg every 3 weeks. Schedule a follow-up visit in 9-12 weeks. Treatment response should be assessed using the INCAT score (at least 1 point improvement) and/or the MRC sum score (>2 points). If there is no response, reconsider the diagnosis, as it is unlikely to be CIDP. Do not use symptom improvement or “halted progression” as proof of response. Refer to a @gbscidp center of excellence if there is no response or if there are doubts about the diagnosis.

[Marcus Pinto, MD, MS @MarcusVPinto]

Are you finding it challenging to counsel patients with peripheral neuropathy? Interested in strategies for managing diabetic, idiopathic, and metabolic syndrome-related neuropathies? Tune into this @neuro_podcast podcast, where we dive deep into these topics. Don’t miss out! Listen on your way to the @AANmember meeting. 🤓 https://t.co/UyULxyTgm1

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

We’d like to thank the @_ENMC
& all participants for their invaluable contributions in making this workshop a success. This lay report summarizes the key discussions and outcomes of the 294th workshop on #paraproteinemia #myopathy (#SLONM & #Amyloidosis)
https://t.co/CQzjSHzTZb

[Journal of Neuromuscular Diseases @journal_nd]

📄 New in JND

Muscle MRI detects early, subtype-specific patterns in idiopathic inflammatory myopathies: https://t.co/PS2nfR42xX

✔️ Distinct signatures across IBM, DM, PM, ASYS, IMNM
✔️ Correlates with muscle strength & CK

#Myositis #MRI #Neuromuscular

[Alberto Vogrig @Vogrig_Alberto]

Why do only some cancer patients develop #paraneoplastic neurological syndromes (PNS)? 🧠
This review explores the immune mechanisms behind PNS and how tumor genetics & immune tolerance shape risk. Kudos to @AKunchok. Open access link: https://t.co/glF1CAIhn5

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

@MarcusVPinto Well said. I am still learning t 😉

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

@Div_Dubey You brought an important immunological perspective that truly enriched the discussion and was instrumental to the success of the workshop. Thank you again for your participation.

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

I am very grateful to @_ENMC for making this 294th workshop on #paraproteinemia #myopathy possible. Thanks to all participants for great discussion and active engagement over the past 3 days.

[Teerin Liewluck, MD, FAAN, FANA @TLiewluck]

What a busy but fulfilling week—an #ENMC workshop in the Netherlands followed by Neurology Grand Rounds at the University of Pennsylvania. Grateful for the opportunity to learn, share, and connect with colleagues. #Myositis #Myopathy

[Hebatallah Rashed, M.D., PhD @Rashedheba83]

I had the pleasure to interview Teerin Liewluck @TLiewluck and Pannathat Soontrapa to discuss monoclonal gammopathies associated myopathies. These myopathies are rare yet treatable. Muscle biopsy reamains a gold standard tool for diagnosis.
@AANEMorg
https://t.co/vyic8UYEhE

[Marcus Pinto, MD, MS @MarcusVPinto]

Dear Neuromuscular Medicine Fellowship Applicants: Apply to our program! Master EMGs, NM ultrasound, and nerve and muscle biopsy interpretation through clinical rotations, elite didactics, and 3 months of electives. We look forward to interviewing and getting to know you!