11th World Muscle Society Satellite Teaching Course
Asilomar Conference Grounds, Fred Farr Forum, Pacific Grove, California, USA
September 30-October 1, 2013


Course description:The emphasis of this course will be on the clinical approach of patients who present with symptoms of weakness and the interpretation of the muscle biopsy. The course will be entirely practical and case reports will be presented to highlight key clinical concepts. There will be the opportunity to discuss the diagnostic approach to patients shown on video, and to look at muscle biopsies. Generous time will be allowed for questions from the audience, and for discussion of difficult topics.

Target Audience:Medical specialists (paediatricians, neurologists, paediatric neurologists, geneticists, neuropathologists) and medical specialists in training, and also other attendees of the WMS congress.

Learning Objectives:At the conclusion of this course, participants should be able to:

  • Recognize the different clinical presentations of neuromuscular disease.
  • Increase familiarity with genetic, pathology and neuroradiology correlations

Needs Assessment:Identified educational needs of the target audience include Lack of Competence and Lack of Knowledge. The educational need for this course was ascertained from several sources including Expert Faculty Opinion, Literature Review, National Practice Guidelines and Research Findings.

Practice Gaps:Neuromuscular conditions are often difficult to recognize and diagnose. Onset may occur in infancy through adulthood and lack of a definitive diagnosis precludes treatment, and may lead to progressive muscle weakness, contractures, scoliosis respiratory insufficiency and in some types intellectual compromise and central nervous system involvement.

Accreditation:The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CME Credit:The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of California, San Diego School of Medicine designates this Live Activity for a maximum of 13 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cultural and Linguistic Competency Statement:This activity is in compliance with California Assembly Bill 1195 which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. Cultural competency is defined as a set of integrated attitudes, knowledge, and skills that enables health care professionals or organizations to care effectively for patients from diverse cultures, groups, and communities. Linguistic competency is defined as the ability of a physician or surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient's primary language. Cultural and linguistic competency was incorporated into the planning of this activity. Additional resources on cultural and linguistic competency and information about AB1195 can be found on the UCSD CME website at http://cme.ucsd.edu

Program:
    Sunday September 29, 2013
          Registered Course Participants with accommodations at Asilomar Conference Grounds:
          Dinner from 6-7pm in Crocker Dining Hall
          Course Faculty: Light meal from 7-9pm in Phoebe Hurst Social Hall

    Monday September 30 - Fred Farr Forum

8.00 Learning from the history and examination, inherited and acquired muscle disease - David Hilton-Jones
9.00 How do we perform a clinical examination on children? Systematic overview on patient's presenting with floppy infant syndrome, and diagnostic approach - Carsten Bonnemann
10.00 Polyneuropathies and the usefulness of EMG - Peter van den Bergh
11.00 Coffee break
11.15 What can we learn from the muscle biopsy? - Anders Oldfors
12.00 Molecular diagnostic testing and what does it mean? - Volker Straub
13.00 Lunch - Box lunch provided
13.45 Delegates are split into two groups (group A [Afterglow Living Room] and group B [Fred Farr Forum])
14.00 Group A1 - Guide to muscle examination in adults and children - Michelle Eagle

Group A2 - Hands-on nerve conduction studies. The techniques for the performance of conduction studies on commonly examined individual upper and lower limb nerves will be illustrated with interpretation of the results - Peter Van den Bergh
15.00 Coffee break
15.15 Group B1 - Guide to muscle examination in adults and children - Michelle Eagle

Group B2 - Hands-on nerve conduction studies. The techniques for the performance of conduction studies on commonly examined individual upper and lower limb nerves will be illustrated with interpretation of the results - Peter Van den Bergh
16.15-18.30 Muscle biopsy session (Fred Farr Forum) - Caroline Sewry, Anders Oldfors, Marianne de Visser
18:30-19:30 Reception in Kiln Patio for all course participants
19:30-22:00 Buffet dinner in Kiln for all course participants

    Tuesday October 1 - Fred Farr Forum

08.00 Systematic overview on patients presenting with limb-girdle and distal muscle weakness,and diagnostic approach - Marianne de Visser
09.00 Management of patients with inherited neuromuscular disorders - Kate Bushby
10.00 Coffee break
10.15 Presentation of difficult, unusual or unsolved cases by participants
12.00-13.00 End of course and lunch in Crocker Dining Hall for participants with accommodations at Asilomar Conference Grounds


Faculty:

Carsten G. Bonnemann, MD
Senior Investigator
Neuromuscular and Neurogenetic Disorders of Childhood Section
NINDS
Bethesda, MD, USA

Marianne de Visser, MD
Academic Medical Center
Department of Neurology
Amsterdam, The Netherlands

Michelle Eagle, PhD, MSc, MCSP
Consultant, physiotherapist
Newcastle Muscle Centre
The Newcastle upon Tyne, United Kingdom

Dr. David Hilton-Jones, MD
Oxford Neuromuscular Centre
West Wing
John Radcliffe Hospital
Oxford, UK

Anders Oldfors, MD, PhD
Professor
Department of Pathology
Sahlgrenska University Hospital
Gothenburg, Sweden

Caroline Sewry, PhD, FRCPath
Professor of Muscle Pathology
Dubowitz Neuromuscular Centre
Institute of Child Health and Great Ormond Street Hospital
London, England
and
Wolfson Centre for Inherited Neuromuscular Diseases
Robert Jones and Agnes Hunt Orthopaedic Hospital
Oswestry, England

Volker Straub, PhD
Professor, Neuromusuclar Genetics
Institute of Human Genetics
University of Newcastle upon Tyne
United Kingdom

Peter Van den Bergh, MD, PhD
Professor of Neurology
Director and coordinator of the Neuromuscular Reference Center
University Hospitals St-Luc
Brussels, Belgium

Congress Chair:
Prof. G. Diane Shelton, PhD

Congress Chair, WMS2013
Department of Pathology, School of Medicine
University of California San Diego
La Jolla, CA, USA

Congress Coordinator:
Carla Grosmann, MD

Associate Clinical Professor
Neurosciences and Pediatrics
University of California San Diego
La Jolla, CA, USA

Disclosure Statement:
It is the policy of the University of California, San Diego School of Medicine to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual's control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or devices. Persons who refuse or fail to disclose are disqualified from participating in the CME activity. Participants will be asked to evaluate whether the speaker's outside interests reflect a possible bias in the planning or presentation of the activity. This information is used to plan future activities.

The following have no relevant financial relationships to disclose:
Carsten G. Bonnemann, MD
Marianne de Visser, MD, PhD
Michelle Eagle, PhD, MSc, MCSP
Carla Grosmann, MD
David Hilton-Jones, MD
Anders Oldfors, MD, PhD
Caroline Sewry, PhD, FRCPath
G. Diane Shelton, PhD
Volker Straub, PhD
Peter Van den Bergh, MD

The CME staff, meeting planners, planning committee and CME committee reviewers do not have any relevant financial relationships to disclose.

This educational activity may contain discussion of unlabeled and/or investigational uses of agents that are not approved by the FDA. Please consult the prescribing information for each product.

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of California, San Diego School of Medicine.

CME Accreditation: The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of California, San Diego School of Medicine designates this Live Activity for a maximum of 13 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Teaching objective: At the conclusion of this course participants should be able to:

  • Recognize the different clinical presentations of neuromuscular disease
  • Increase familiarity with genetic, pathology and neuroradiology correlations

Target audience: Medical specialists (paediatricians, neurologists, paediatric neurologists, geneticists, neuropathologists) and medical specialists in training, and also other attendees of the WMS congress.

Maximum attendants: 45

Registration Deadline: August 31, 2013

Course description: The emphasis of this course will be on the clinical approach of patients who present with symptoms of weakness and the interpretation of the muscle biopsy. The course will be entirely practical and case reports will be presented to highlight key clinical concepts. There will be the opportunity to discuss the diagnostic approach to patients shown on video, and to look at muscle biopsies. Generous time will be allowed for questions from the audience, and for discussion of difficult topics.


Participants are encouraged to bring difficult, unusual or unsolved cases for discussion

For this purpose, each participant will be asked to present one neuromuscular case to be presented and discussed.

For every case he/she should prepare:

Two Powerpoint slides:

  • Slide 1 should contain: a clinical picture/clinical video demonstrating major clinical characteristics (onset; clinical course; CK; NCV; heredity; other)
  • Slide 2 should contain: one pertinent piece of information (e.g. muscle or brain imaging; a family tree; immunofluorescence or Western blot data).

The presentation should not take longer than 3 minutes.

Bring a maximum of 5 Powerpoint slides on a thumb drive showing the most salient muscle biopsy findings. Slides should be loaded onto the main course computer prior to the beginning of the course or during breaks.