{"id":15242,"date":"2018-09-26T17:11:33","date_gmt":"2018-09-26T09:11:33","guid":{"rendered":"https:\/\/hksnmd.org\/%e8%82%8c%e8%82%89%e7%a5%9e%e7%b6%93%e6%b4%bb%e6%aa%a2\/"},"modified":"2022-11-15T15:06:50","modified_gmt":"2022-11-15T07:06:50","slug":"muscle-nerve-biopsy","status":"publish","type":"page","link":"https:\/\/hksnmd.org\/en\/diagnostic-tests\/muscle-nerve-biopsy\/","title":{"rendered":"Muscle \/ Nerve Biopsy"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"15242\" class=\"elementor elementor-15242 elementor-12202\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-79c81622 elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"79c81622\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-3bb92dd6\" data-id=\"3bb92dd6\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-25a8cf27 elementor-widget elementor-widget-menu-anchor\" data-id=\"25a8cf27\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"faq1\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1851f036 elementor-widget elementor-widget-spacer\" data-id=\"1851f036\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-705c0dde elementor-widget elementor-widget-heading\" data-id=\"705c0dde\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Classification of the affected site in Neuromuscular diseases ?<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f527f6e elementor-widget elementor-widget-text-editor\" data-id=\"f527f6e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>There are four main categories for neuromuscular diseases based on the affected site of the diseases:<br \/>\n(1)motor neurons<br \/>\n(2)peripheral nerve<br \/>\n(3)neuromuscular junction and muscle<br \/>\n(4)the diseases of muscle are in general coined myopathy.<\/p>\n<p>Onset of neuromuscular disease can be acute, subacute and chronic. Depending on affected site, the clinical manifestations are widely different. The most common symptoms are muscle weakness, muscular atrophy and muscle pain.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1876b3d7 elementor-widget elementor-widget-menu-anchor\" data-id=\"1876b3d7\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"faq2\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4dbc25ee elementor-widget elementor-widget-spacer\" data-id=\"4dbc25ee\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-663a7f3f elementor-widget elementor-widget-heading\" data-id=\"663a7f3f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Clinical Evaluation ?<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-296714c9 elementor-widget elementor-widget-text-editor\" data-id=\"296714c9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>A detailed clinical history and family history coped with careful physical examination are first step towards a correct diagnosis. Other investigations include blood tests, tests for suspected hereditary neuromuscular diseases, electromyography, MRI or muscle ultrasound and muscle &amp; nerve biopsies.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61c94fc1 elementor-widget elementor-widget-menu-anchor\" data-id=\"61c94fc1\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"faq3\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2a253112 elementor-widget elementor-widget-spacer\" data-id=\"2a253112\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fc7fd66 elementor-widget elementor-widget-heading\" data-id=\"fc7fd66\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Muscle Biopsy Diagnostic Test ?<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bfd773 elementor-widget elementor-widget-text-editor\" data-id=\"bfd773\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Muscle biopsy is a special procedure to precure a piece of muscle from diseased area. It assesses structural alternations in muscle fibers to provide evidence for diagnosis of neuromuscular diseases.<br \/>\nThere are two biopsy methods:<br \/>\n(1)needle biopsy performed under localized anesthesia.<br \/>\n(2)open biopsy, which is conducted when a patient is under general anesthesia.<\/p>\n<p>The choice of biopsy methods is usually based on clinical assessment. Needle biopsy can be used for various myositis, when there is inflammatory infiltrate in the muscle. Open biopsy is able to obtain a large piece of muscle about 1.0 cm in greatest dimension with good muscle fiber orientation for detailed microscopic and electron microscopic studies. While needle biopsy is often performed by neurologists at patient\u2019s bedside, open biopsy is arranged by surgeons or orthopedic surgeons. Biopsy site is planned according to physical signs, electromyographic findings and MRI or muscle ultrasound features.<\/p>\n<p>After the biopsy procedure, non-formalin fixed fresh muscle tissue is sending to histopathology laboratory for tissue processing, special muscle enzyme stains and even electron microscopy.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7a8e54c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7a8e54c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-0bc0388\" data-id=\"0bc0388\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-33eb3cc elementor-widget elementor-widget-text-editor\" data-id=\"33eb3cc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><figure id=\"attachment_12364\" aria-describedby=\"caption-attachment-12364\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/normal-muscle-fibers-pic1-e1535702488711.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-12364 size-medium\" src=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/normal-muscle-fibers-pic1-e1535702488711-300x225.jpg\" alt=\"\u5716\u4e00\ufe30\u6b63\u5e38\u808c\u7e96\u7dad\u7d30\u80de\u662f\u591a\u908a\u5f62\u7684\uff0c\u5927\u5c0f\u4e00\u81f4\uff0c\u7d30\u80de\u6838\u4f4d\u65bc\u808c\u7e96\u7dad\u7d30\u80de\u7684\u908a\u7de3\u3002\" width=\"300\" height=\"225\" srcset=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/normal-muscle-fibers-pic1-e1535702488711-300x225.jpg 300w, https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/normal-muscle-fibers-pic1-e1535702488711.jpg 577w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-12364\" class=\"wp-caption-text\"><strong>Fig1. Normal muscle fibers are polygonal shaped and uniform sized with peripheral nuclei.<\/strong><\/figcaption><\/figure><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-9e64c3a\" data-id=\"9e64c3a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-088198f elementor-widget elementor-widget-text-editor\" data-id=\"088198f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><figure id=\"attachment_12367\" aria-describedby=\"caption-attachment-12367\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic2.jpg\"><img decoding=\"async\" class=\"wp-image-12367 size-medium\" src=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic2-300x225.jpg\" alt=\"\u5716\u4e8c\ufe30\u75c5\u4f8b\u4e00\u808c\u7e96\u7dad\u6027\u808c\u75c5\uff1a\u808c\u7e96\u7dad\u7d30\u80de\u5f62\u614b\u3001\u5927\u5c0f\u4e0d\u4e00\u81f4\uff0c\u90e8\u5206\u808c\u7e96\u7dad\u5305\u6f3f\u5167\u6709\u5305\u6db5\u9ad4\u3002\" width=\"300\" height=\"225\" srcset=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic2-300x225.jpg 300w, https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic2.jpg 577w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-12367\" class=\"wp-caption-text\"><strong>Fig 2. A case of myofibrillar myopathy. Muscle fiber varies in size and shape with intracytoplasmic inclusions.<\/strong><\/figcaption><\/figure><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-9987121\" data-id=\"9987121\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-714367f elementor-widget elementor-widget-text-editor\" data-id=\"714367f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><figure id=\"attachment_12370\" aria-describedby=\"caption-attachment-12370\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic3.jpg\"><img decoding=\"async\" class=\"wp-image-12370 size-medium\" src=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic3-300x225.jpg\" alt=\"\u5716\u4e09\ufe30\u8207\u5716\u4e8c\u75c5\u4f8b\u76f8\u540c\u3002\u4e09\u8272\u67d3\u8272\u986f\u793a\u90e8\u5206\u808c\u7e96\u7dad\u5305\u6f3f\u5167\u6709\u5305\u6db5\u9ad4\u3002\" width=\"300\" height=\"225\" srcset=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic3-300x225.jpg 300w, https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic3.jpg 577w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-12370\" class=\"wp-caption-text\"><strong>Fig 3. Same case as in Fig 2. Trichrome stain highlights intracytoplasmic inclusions.<\/strong><\/figcaption><\/figure><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-12f3226\" data-id=\"12f3226\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f2399ce elementor-widget elementor-widget-text-editor\" data-id=\"f2399ce\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><figure id=\"attachment_12373\" aria-describedby=\"caption-attachment-12373\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-12373 size-medium\" src=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic4-300x225.jpg\" alt=\"\u5716\u56db\ufe30\u8207\u5716\u4e8c\u75c5\u4f8b\u76f8\u540c\u3002\u6c27\u5316\u808c\u9176\u67d3\u8272\u986f\u793a\u90e8\u5206\u808c\u7e96\u7dad\u5305\u6f3f\u5167\u6709\u5305\u6db5\u9ad4\u4e26\u4e14\u67d3\u8272\u8b8a\u6dfa\u3002\" width=\"300\" height=\"225\" srcset=\"https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic4-300x225.jpg 300w, https:\/\/hksnmd.org\/wp-content\/uploads\/2018\/08\/myofibrillar-myopathy-muscle-fibers-pic4.jpg 577w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-12373\" class=\"wp-caption-text\"><strong>Fig 4. Same case as in Fig 2. Oxidative muscle enzyme stain shows intracytoplasmic inclusions and light stained muscle fibers.<\/strong><\/figcaption><\/figure><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-40c582c6 elementor-widget elementor-widget-text-editor\" data-id=\"40c582c6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Before muscle biopsy is carried out, neurologists are going to order a series tests to rule out endocrine diseases, such as thyroid, adrenal dysfunction, and metabolic myopathy, such as Pompe disease. Muscle biopsy can provide evidence to confirm the diagnosis of myositis, i.e. polymyositis, dermatomyositis and toxic myopathy and vasculitis. It also helps the diagnosis of denervation and myopathies with structural abnormalities, like mitochondrial myopathy, lipid storage myopathy and some limb girdle dystrophy.<\/p>\n<p>Nerve biopsy is to assist diagnosis of peripheral neuropathy. A proper consultation with neurologists is recommended before the biopsy. Microscopic examination of nerve sometimes may help the diagnosis of vasculitis, chronic inflammatory demyelinating polyneuropathy, amyloidosis, demyelination and axonal degeneration. Because of segmental involvement of the diseases, nerve biopsy is not always informative, hence it has limited diagnostic value. Nerve biopsy is an open biopsy. The biopsied nerve is mostly from sural nerve near the ankle joint.<\/p>\n<p><strong>Summary<br \/>\n<\/strong>Diagnosis of neuromuscular disease is a stepwise exercise following an algorithm, by which differential considerations are excluded or included. The diagnostic pathway involves a number of tests by multidisciplinary professionals, including clinical lab, imaging, electronic physiology and muscle\/nerve biopsy. For some instances, the confirmatory diagnosis may take years to establish.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6f7b924 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"6f7b924\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2c74c33 elementor-align-center elementor-widget elementor-widget-global elementor-global-28736 elementor-global-28427 elementor-widget-button\" data-id=\"2c74c33\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/hksnmd.org\/en\/patient-and-family-guidance\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-circle-left\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 504C119 504 8 393 8 256S119 8 256 8s248 111 248 248-111 248-248 248zm28.9-143.6L209.4 288H392c13.3 0 24-10.7 24-24v-16c0-13.3-10.7-24-24-24H209.4l75.5-72.4c9.7-9.3 9.9-24.8.4-34.3l-11-10.9c-9.4-9.4-24.6-9.4-33.9 0L107.7 239c-9.4 9.4-9.4 24.6 0 33.9l132.7 132.7c9.4 9.4 24.6 9.4 33.9 0l11-10.9c9.5-9.5 9.3-25-.4-34.3z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Back to Index<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6001e765 elementor-widget elementor-widget-spacer\" data-id=\"6001e765\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-f8f5b0c\" data-id=\"f8f5b0c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-85db538 elementor-align-left elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"85db538\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#faq1\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-info\" viewBox=\"0 0 192 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M20 424.229h20V279.771H20c-11.046 0-20-8.954-20-20V212c0-11.046 8.954-20 20-20h112c11.046 0 20 8.954 20 20v212.229h20c11.046 0 20 8.954 20 20V492c0 11.046-8.954 20-20 20H20c-11.046 0-20-8.954-20-20v-47.771c0-11.046 8.954-20 20-20zM96 0C56.235 0 24 32.235 24 72s32.235 72 72 72 72-32.235 72-72S135.764 0 96 0z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Classification of the affected site in Neuromuscular diseases ?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#faq2\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-info\" viewBox=\"0 0 192 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M20 424.229h20V279.771H20c-11.046 0-20-8.954-20-20V212c0-11.046 8.954-20 20-20h112c11.046 0 20 8.954 20 20v212.229h20c11.046 0 20 8.954 20 20V492c0 11.046-8.954 20-20 20H20c-11.046 0-20-8.954-20-20v-47.771c0-11.046 8.954-20 20-20zM96 0C56.235 0 24 32.235 24 72s32.235 72 72 72 72-32.235 72-72S135.764 0 96 0z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Clinical Evaluation ?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#faq3\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-info\" viewBox=\"0 0 192 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M20 424.229h20V279.771H20c-11.046 0-20-8.954-20-20V212c0-11.046 8.954-20 20-20h112c11.046 0 20 8.954 20 20v212.229h20c11.046 0 20 8.954 20 20V492c0 11.046-8.954 20-20 20H20c-11.046 0-20-8.954-20-20v-47.771c0-11.046 8.954-20 20-20zM96 0C56.235 0 24 32.235 24 72s32.235 72 72 72 72-32.235 72-72S135.764 0 96 0z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Muscle Biopsy Diagnostic Test ?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f06ae92 elementor-widget elementor-widget-global elementor-global-28718 elementor-global-28581 elementor-widget-text-editor\" data-id=\"f06ae92\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Share to:<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c7ce383 elementor-share-buttons--view-icon elementor-grid-6 elementor-grid-mobile-3 elementor-share-buttons--shape-circle elementor-share-buttons--skin-gradient elementor-share-buttons--color-official elementor-widget elementor-widget-global elementor-global-28732 elementor-global-28571 elementor-widget-share-buttons\" data-id=\"c7ce383\" data-element_type=\"widget\" data-widget_type=\"share-buttons.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-grid\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_facebook\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on facebook\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fab-facebook\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256C504 119 393 8 256 8S8 119 8 256c0 123.78 90.69 226.38 209.25 245V327.69h-63V256h63v-54.64c0-62.15 37-96.48 93.67-96.48 27.14 0 55.52 4.84 55.52 4.84v61h-31.28c-30.8 0-40.41 19.12-40.41 38.73V256h68.78l-11 71.69h-57.78V501C413.31 482.38 504 379.78 504 256z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_email\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on email\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fas-envelope\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M502.3 190.8c3.9-3.1 9.7-.2 9.7 4.7V400c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V195.6c0-5 5.7-7.8 9.7-4.7 22.4 17.4 52.1 39.5 154.1 113.6 21.1 15.4 56.7 47.8 92.2 47.6 35.7.3 72-32.8 92.3-47.6 102-74.1 131.6-96.3 154-113.7zM256 320c23.2.4 56.6-29.2 73.4-41.4 132.7-96.3 142.8-104.7 173.4-128.7 5.8-4.5 9.2-11.5 9.2-18.9v-19c0-26.5-21.5-48-48-48H48C21.5 64 0 85.5 0 112v19c0 7.4 3.4 14.3 9.2 18.9 30.6 23.9 40.7 32.4 173.4 128.7 16.8 12.2 50.2 41.8 73.4 41.4z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_twitter\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on twitter\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fab-twitter\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M459.37 151.716c.325 4.548.325 9.097.325 13.645 0 138.72-105.583 298.558-298.558 298.558-59.452 0-114.68-17.219-161.137-47.106 8.447.974 16.568 1.299 25.34 1.299 49.055 0 94.213-16.568 130.274-44.832-46.132-.975-84.792-31.188-98.112-72.772 6.498.974 12.995 1.624 19.818 1.624 9.421 0 18.843-1.3 27.614-3.573-48.081-9.747-84.143-51.98-84.143-102.985v-1.299c13.969 7.797 30.214 12.67 47.431 13.319-28.264-18.843-46.781-51.005-46.781-87.391 0-19.492 5.197-37.36 14.294-52.954 51.655 63.675 129.3 105.258 216.365 109.807-1.624-7.797-2.599-15.918-2.599-24.04 0-57.828 46.782-104.934 104.934-104.934 30.213 0 57.502 12.67 76.67 33.137 23.715-4.548 46.456-13.32 66.599-25.34-7.798 24.366-24.366 44.833-46.132 57.827 21.117-2.273 41.584-8.122 60.426-16.243-14.292 20.791-32.161 39.308-52.628 54.253z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_whatsapp\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on whatsapp\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fab-whatsapp\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M380.9 97.1C339 55.1 283.2 32 223.9 32c-122.4 0-222 99.6-222 222 0 39.1 10.2 77.3 29.6 111L0 480l117.7-30.9c32.4 17.7 68.9 27 106.1 27h.1c122.3 0 224.1-99.6 224.1-222 0-59.3-25.2-115-67.1-157zm-157 341.6c-33.2 0-65.7-8.9-94-25.7l-6.7-4-69.8 18.3L72 359.2l-4.4-7c-18.5-29.4-28.2-63.3-28.2-98.2 0-101.7 82.8-184.5 184.6-184.5 49.3 0 95.6 19.2 130.4 54.1 34.8 34.9 56.2 81.2 56.1 130.5 0 101.8-84.9 184.6-186.6 184.6zm101.2-138.2c-5.5-2.8-32.8-16.2-37.9-18-5.1-1.9-8.8-2.8-12.5 2.8-3.7 5.6-14.3 18-17.6 21.8-3.2 3.7-6.5 4.2-12 1.4-32.6-16.3-54-29.1-75.5-66-5.7-9.8 5.7-9.1 16.3-30.3 1.8-3.7.9-6.9-.5-9.7-1.4-2.8-12.5-30.1-17.1-41.2-4.5-10.8-9.1-9.3-12.5-9.5-3.2-.2-6.9-.2-10.6-.2-3.7 0-9.7 1.4-14.8 6.9-5.1 5.6-19.4 19-19.4 46.3 0 27.3 19.9 53.7 22.6 57.4 2.8 3.7 39.1 59.7 94.8 83.8 35.2 15.2 49 16.5 66.6 13.9 10.7-1.6 32.8-13.4 37.4-26.4 4.6-13 4.6-24.1 3.2-26.4-1.3-2.5-5-3.9-10.5-6.6z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_telegram\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on telegram\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fab-telegram\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zm121.8 169.9l-40.7 191.8c-3 13.6-11.1 16.9-22.4 10.5l-62-45.7-29.9 28.8c-3.3 3.3-6.1 6.1-12.5 6.1l4.4-63.1 114.9-103.8c5-4.4-1.1-6.9-7.7-2.5l-142 89.4-61.2-19.1c-13.3-4.2-13.6-13.3 2.8-19.7l239.1-92.2c11.1-4 20.8 2.7 17.2 19.5z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-grid-item\">\n\t\t\t\t\t\t<div\n\t\t\t\t\t\t\tclass=\"elementor-share-btn elementor-share-btn_print\"\n\t\t\t\t\t\t\trole=\"button\"\n\t\t\t\t\t\t\ttabindex=\"0\"\n\t\t\t\t\t\t\taria-label=\"Share on print\"\n\t\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-share-btn__icon\">\n\t\t\t\t\t\t\t\t<svg class=\"e-font-icon-svg e-fas-print\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M448 192V77.25c0-8.49-3.37-16.62-9.37-22.63L393.37 9.37c-6-6-14.14-9.37-22.63-9.37H96C78.33 0 64 14.33 64 32v160c-35.35 0-64 28.65-64 64v112c0 8.84 7.16 16 16 16h48v96c0 17.67 14.33 32 32 32h320c17.67 0 32-14.33 32-32v-96h48c8.84 0 16-7.16 16-16V256c0-35.35-28.65-64-64-64zm-64 256H128v-96h256v96zm0-224H128V64h192v48c0 8.84 7.16 16 16 16h48v96zm48 72c-13.25 0-24-10.75-24-24 0-13.26 10.75-24 24-24s24 10.74 24 24c0 13.25-10.75 24-24 24z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-44dfc16 elementor-align-left elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-global elementor-global-25829 elementor-global-25650 elementor-widget-icon-list\" data-id=\"44dfc16\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-bell\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M224 512c35.32 0 63.97-28.65 63.97-64H160.03c0 35.35 28.65 64 63.97 64zm215.39-149.71c-19.32-20.76-55.47-51.99-55.47-154.29 0-77.7-54.48-139.9-127.94-155.16V32c0-17.67-14.32-32-31.98-32s-31.98 14.33-31.98 32v20.84C118.56 68.1 64.08 130.3 64.08 208c0 102.3-36.15 133.53-55.47 154.29-6 6.45-8.66 14.16-8.61 21.71.11 16.4 12.98 32 32.1 32h383.8c19.12 0 32-15.6 32.1-32 .05-7.55-2.61-15.27-8.61-21.71z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\"><strong style=\"text-decoration:underline\">Learn More<\/strong><\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/hksnmd.org\/en\/community-rehabilitation-information\/\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Community Rehabilitation Information<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a 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There are four main categories for neuromuscular diseases based on the affected site of the diseases: (1)motor neurons (2)peripheral nerve (3)neuromuscular junction and muscle (4)the diseases of muscle are in general coined myopathy. Onset of neuromuscular disease can be acute, subacute and chronic. Depending on affected [&hellip;]<\/p>\n","protected":false},"author":213,"featured_media":0,"parent":6447,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-15242","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Muscle \/ Nerve Biopsy - The Hong Kong Society of Neuromuscular Diseases<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/hksnmd.org\/en\/diagnostic-tests\/muscle-nerve-biopsy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Muscle \/ Nerve Biopsy - The Hong Kong Society of Neuromuscular Diseases\" \/>\n<meta property=\"og:description\" content=\"Classification of the affected site in Neuromuscular diseases ? There are four main categories for neuromuscular diseases based on the affected site of the diseases: (1)motor neurons (2)peripheral nerve (3)neuromuscular junction and muscle (4)the diseases of muscle are in general coined myopathy. Onset of neuromuscular disease can be acute, subacute and chronic. 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There are four main categories for neuromuscular diseases based on the affected site of the diseases: (1)motor neurons (2)peripheral nerve (3)neuromuscular junction and muscle (4)the diseases of muscle are in general coined myopathy. Onset of neuromuscular disease can be acute, subacute and chronic. 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