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arkanalabs.bsky.social
35-year-old previously healthy woman presented with dark urine, severe pain & swelling in bilateral lower extremity 1 day post marathon training. She has a history of muscle aches following exercise. Her CPK was around 14,000.

#NeuroNotes #neuropath #neuromuscular
November 19, 2024 at 3:30 PM
arkanalabs.bsky.social
The images show a normal neuromuscular junction.

Note the folded post-synaptic membrane of the skeletal muscle fiber, and synaptic vesicles in the pre-synaptic motor nerve terminal boutons (latter best seen in the high magnification image).

#neuromuscularpathology #neuronotes
arkanalabs.bsky.social Arkana Labs @arkanalabs.bsky.social · Dec 10
This 15 y/o patient presented with complaints of progressive muscle weakness. Muscle biopsy was performed. A few small intramuscular nerve twigs were present in the biopsy tissue.

What normal structure is demonstrated in the two provided electron microscopic images? #neuromuscularbx #NeuroNotes
December 11, 2024 at 2:31 PM
arkanalabs.bsky.social
(1/2) The patient is a 62-year-old woman with asthma, GERD, moderate alcohol intake, and hypertension who presents with 4 weeks of weakness, arthralgia, and fatigue. Her family history is significant for breast cancer and alcohol abuse.

#DiagnoseThis #NeuroNotes #neuropath #neuromuscular
January 27, 2025 at 2:22 PM
arkanalabs.bsky.social
1/ What is the best pathologic diagnosis? Clinical history in thread.

#NeuroNotes #neuropath #pathology #neuromuscularpath
March 2, 2026 at 1:50 PM
arkanalabs.bsky.social
We have launched four neuropathology quizzes on our website! If you're interested in testing your neuropathology wisdom, head to our site. #neuropathology #neuromuscular #pathology #neuropath #neuronotes

Education
At Arkana Laboratories, we put the education of the next generation first! We offer quizzes, a pathology fellowship, and resident rotations.
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March 2, 2026 at 1:55 PM
arkanalabs.bsky.social
What is the most likely diagnosis?

Patient’s clinical history is included in the thread below 👇

#NeuroNotes #neuromuscular #neuropath
January 20, 2025 at 2:25 PM
timholt2024.bsky.social
What if an alien wrote a review of #AncientAliens? See what that looks like in Part IV of my #Novella: The Critic
#scifi #writing #sciencefiction #writer #speculativefiction holtwrites2026.tumblr.com/post/8265604...
The Critic Part IV: The Review Tim Holt
The Review He absorbed all the seasons with the glee of a youngling who had just discovered his father’s secret stash of Vlorn holoviews. He took neuronotes on his thought recorder like he had never.....
holtwrites2026.tumblr.com
September 1, 2026 at 1:34 PM
arkanalabs.bsky.social
This 65-year-old patient presented with bilateral symmetrical proximal upper and lower extremity muscle weakness, dysphagia and skin rash. 🧵

#neuropath #NeuroNotes #pathX #pathology
February 18, 2025 at 2:59 PM
arkanalabs.bsky.social
This 50-year-old patient underwent muscle biopsy to evaluate for cramps and myalgias.

What is the structure in the image?

#DiagnoseThis #NeuroNotes #neuropath #neuromuscular
March 10, 2025 at 2:11 PM
arkanalabs.bsky.social
What is a likely underlying cause of this patient’s disorder?

A.) PHKA2 mutation
B.) MMA deficiency
C.) IDH1 deficiency
D.) PYGM mutation

#NeuroNotes #neuropath #neuromuscular
November 19, 2024 at 3:30 PM
arkanalabs.bsky.social
1/ This 45-year-old patient underwent muscle biopsy to evaluate for muscle weakness. The biopsy showed denervation type changes (neurogenic atrophy). An unusual looking muscle fiber was noted on paraffin sections.

#pathtwitter #pathx #neuromuscularpath #neuropath #neuronotes
April 14, 2025 at 3:30 PM
arkanalabs.bsky.social
This 60-year-old patient presented with complaints of progressive bilateral lower extremity weakness of two weeks duration. Laboratory studies showed marked elevation of CPK (rhabdomyolysis).

What is the von Kossa stain showing?

#NeuroNotes #pathology #neuromuscular #neuropath
March 3, 2025 at 2:30 PM
arkanalabs.bsky.social
(1/2) The patient is a 69-year-old male who presented with complaints of proximal lower extremity muscle weakness and BMI of 37. His home medication list includes atorvastatin. Bilateral thigh biopsies were performed to evaluate for myopathy.

#NeuroNotes #neuropath #pathology #neuromuscularpath
December 29, 2025 at 3:30 PM
arkanalabs.bsky.social
#NeuroNotes This 45-year old patient presented with complaints of muscle weakness. Prior genetic testing detected a heterozygous variant of uncertain significance (VUS) in the GSN gene (Pathogenic variants in this gene are associated with autosomal dominant gelsolin amyloidosis). (1/2)
February 25, 2025 at 2:10 PM
arkanalabs.bsky.social
(2/2) She has been treated initially with prednisone with only mild improvement. Her lab results show a highest CK of 1582, alkaline phosphatase of 121, CRP of 35.9, and an absolute eosinophilia.

What is the diagnosis?

#DiagnoseThis #NeuroNotes #neuropath #neuromuscular
January 27, 2025 at 2:22 PM
arkanalabs.bsky.social
What enzyme is deficient in this patient’s disease?

A. Acid alpha-glucosidase
B. Glycogen phosphorylase
C. Glucose-6-phosphate translocase
D. Myophosphorylase

#NeuroNotes #neuropath #pathology #neuromuscularpath #PathX #PathTwitter
September 9, 2026 at 7:50 PM
arkanalabs.bsky.social
(see prior Arkana Neuronotes: www.arkanalabs.com/collagen-poc...)
Collagen Pockets in Nerve Biopsy
When small unmyelinated axons are lost to damage, collagen pockets in nerve biopsies are one morphologic sign of axonal loss.
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September 3, 2026 at 5:39 PM
arkanalabs.bsky.social
In the supplied medium and high magnification images from electron microscopy, which of the labeled structures represents an intact unmyelinated small diameter axon?

A.
B.
C.
D.

#NeuroNotes #neuropath #pathology #neuromuscularpath
September 2, 2026 at 1:20 PM
arkanalabs.bsky.social
(2/2) What term would you use to describe the changes in this patient’s nerve biopsy?
A. Demyelinating
B. Perineuritis
C. Perineurioma
D. Traumatic neuroma

#NeuroNotes #neuropath #pathology #neuromuscularpath
July 1, 2026 at 1:03 PM
josephchataignon.bsky.social
I wrote a first blog post, I'll be writing about AI and LLMs. Feedback s welcome
blog.chataignon.org/joseph/2025-...
Why ChatGPT can’t spell – Neuronotes
blog.chataignon.org
February 19, 2025 at 4:32 PM
arkanalabs.bsky.social
The answer is: Necrotizing Myopathy

To learn more, head to our blog: www.arkanalabs.com/needle-core-...

#neuropath #neuromuscular #neuronotes #pathology
Needle Core Biopsy Muscle
Clinical History:This 50-year-old patient presented with progressively worsening muscle weakness of one month duration. Their past medical history was significant…
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March 3, 2026 at 4:23 PM
arkanalabs.bsky.social
The answer is: Denervation (neurogenic atrophy) and incidental vascular amyloid deposition

To learn more, head to our blog: www.arkanalabs.com/denervation-...

#neuropath #neuromuscular #neuronotes #pathology
Denervation with Incidental Vascular Amyloid
Clinical History:This 76-year-old male presented with complaints of muscle pain. Their past medical history is significant for Sjogren’s syndrome, fibromyalgia,…
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January 22, 2026 at 4:00 PM
arkanalabs.bsky.social
The answer is: Vacuolar myopathy due to hydroxychloroquine toxicity

To learn more, head to our blog: www.arkanalabs.com/toxic-vacuol...

#neuropath #neuromuscular #neuronotes #pathology
Toxic Vacuolar Myopathy Due to Hydroxychloroquine
Clinical History:This 50-year-old patient presented with a one year history of of persistent muscle weakness. They also had shortness of…
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January 8, 2026 at 3:11 PM
arkanalabs.bsky.social
1/ This 50-year-old patient presented with a one yearhistory of of persistent muscle weakness. They also had shortness of breath with exertion.

#NeuroNotes #neuropath #pathology #neuromuscularpath
January 7, 2026 at 2:01 PM
arkanalabs.bsky.social
The answer is: D.) Duchenne muscular dystrophy

To learn more, head to our blog: www.arkanalabs.com/sporadic-lat...

#neuropath #neuromuscular #neuronotes #pathology
Sporadic Late-Onset Nemaline Myopathy
Clinical History:The patient is a 69-year-old male who presented with complaints of proximal lower extremity muscle weakness and BMI of…
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December 30, 2025 at 2:12 PM