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It is unknown if patients with neuromuscular diseases prefer in-person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in-person visits, and the factors influencing such preferences.Telephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed.Five hundred and twenty surveys were completed. Twenty-six percent of respondents preferred virtual visits, while 50% preferred in-person visits. Sixty-four percent reported physical interaction as "very important." For receiving a new diagnosis, 55% preferred in-person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in-person visits than no preference.Although neither technology, privacy, nor finance burdened patients in our study, more patients preferred in-person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in-person encounters had high importance for patients, reflecting differences in the perception of the patient-physician relationship between virtual and in-person visits.

INTRODUCTION/AIM: The immunopathology of autoimmune seronegative myasthenia gravis (SN MG) is poorly understood. Our objective was to determine immune profiles associated with a diagnosis of SN MG. METHODS: We performed high-dimensional flow cytometry on blood samples from SN MG patients (N=68), healthy controls (N=46), and acetylcholine receptor antibody (AChR+) MG patients (N=27). We compared 12 immune cell subsets in SN MG to controls using logistic modeling via a discovery-replication design. An exploratory analysis fit a multinomial model comparing AChR+ MG and controls to SN MG. RESULTS: An increase in CD19(+)CD20(-)CD38(hi) plasmablast frequencies was associated with lower odds of being a SN MG case in both the discovery and replication analyses (discovery p-value=0.0003, replication p-value=0.0021). IL-21 producing helper T cell frequencies were associated with a diagnosis of AChR+ MG (p=0.004). DISCUSSION: Reduced plasmablast frequencies are strongly associated with a SN MG diagnosis and may be a useful diagnostic biomarker in the future.

Introduction Objective information on longitudinal disease progression in inclusion body myositis (IBM) is lacking. Methods Longitudinal dynamometry and functional status data were collated from a cohort of IBM patients. Annual change was calculated by means of linear modeling. Trajectories of change in grip, knee extension, IBM Functional Rating Scale (IBM‐FRS) and Neuromuscular Symptom Score (NSS) were identified by means of latent growth mixture modeling. Results Data were collated from 75 IBM patients (348 person‐years follow‐up). Annual strength loss was greatest for pinch (−10%) and knee extension (−4%). Functional deterioration was greatest for males. Three distinct trajectory groups were identified. Rapid deterioration trajectory for grip strength was associated with younger diagnosis age. Rapid deterioration for knee extension strength was associated with older age of diagnosis. Discussion This study has quantified strength change in IBM and identified distinct trajectory groups, which will aid prognostication and stratification for inclusion into future clinical trials., See editorial on pages 7–9 in this issue.

INTRODUCTION This study sought to evaluate needle electromyography (EMG) practice patterns among electromyographers with patients taking novel oral anticoagulants (NOAC). METHODS A survey questionnaire was sent to members of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) via email web link. Anonymous survey responses were collected through an online website. RESULTS Fifty-eight AANEM members responded, 28 (48%) of whom worked at a teaching hospital and 30 (52%) of whom worked in a private setting. Fifty-four (93%) responders perform needle EMG on patients taking NOACs. Twenty-nine (50%) responders examine paraspinal muscles, and 20 (40%) responders examine facial muscles. Among 14 responders who perform single-fiber EMG (SFEMG), 8 examine patients taking NOACs. DISCUSSION Although most of the electromyographers perform needle EMG on patients taking NOACs, they reported variable practice patterns in examination of the paraspinal and facial muscles and in performing SFEMG. A prospective risk-benefit study is required. Muscle Nerve 58: 307-309, 2018.

Introduction: Nerve entrapment due to osseous callus formation is a rare complication after bone fracture. Electrodiagnostic studies and routine radiographic imaging often fail to demonstrate the pathology. The diagnosis is difficult and is often made incidentally upon surgical exploration. Nerve ultrasonography has not been used routinely to assess such lesions. Methods: We report 5 cases of nerve entrapment in osseous callus after fractures that occurred in 2011 and 2012. The diagnosis was made by ultrasound (US). We then performed a review of the relevant literature. Conclusions: US is becoming an invaluable tool for diagnosing peripheral nerve entrapments. The current cases suggest that nerve US should be strongly considered as an adjunctive diagnostic tool for nerve palsies developing after trauma. Muscle Nerve 48: 445–450, 2013