[Verse 1] [Lead Vocalist — sung, accusing only in the consonants. “F.P.L.” / “F.D.P.” dotted and given full notes.] Pronator Teres syndrome; if anterior Interosseous Syndrome, motor branch of median nerve, no sensory symptoms. If the median nerve lesion, more widespread sensory and motor. [Verse 2] [Lead Vocalist — three sites as three rising phrases, same melody.] Radial Nerve Lesions, in the axilla "crutches - including the triceps", at the elbow "purely motor posterior interosseous", by handcuffs "superficial radial nerve". [Verse 3] [Lead Vocalist — wrist-to-elbow map, no bark.] Ulnar lesions at the wrist, in the palm, cubital tunnel, behind the medial epicondyle. [Verse 4] [Lead Vocalist — warmer on pregnancy, then dry.] Femoral neuropathy; diabetes, retroperitoneal masses, at the inguinal ligament. Meralgia Paresthetica, lateral femoral cutaneous nerve; obesity or diabetes, during pregnancy. [Verse 5] [Lead Vocalist — crossed-legs line almost kind; foot-drop is the fall.] Fibular nerve, in the head and neck of the fibula "sitting with crossed legs or wearing high boots"; weakness of dorsiflexion and eversion of the foot; numbness of the anterolateral calf and dorsum of the foot. [Verse 6] [Lead Vocalist — heel spared, held half a beat.] Tarsal Tunnel Syndrome, tibial nerve; numbness over the bottom of the foot, sparing the heel [Chorus] [Lead Vocalist — hook. “D.M.” two short notes. Taper sung as a descent. Harmonies only on “prednisone.”] Bell palsy, more common in pregnancy and D.M. If due to herpes zoster, vesicles in the external ear canal. Treat with prednisone for 5 days followed by a 5-day taper; Acyclovir if evidence of herpetic vesicles. [Verse 7] [Lead Vocalist — chronic line long; “C.5–C.6” named clean.] Cervical spondylosis results from chronic disk degeneration, with herniation, secondary calcification, and osteophytic outgrowths. C.5–C.6 most common. Treat; cervical collar, injection of anesthetics or corticosteroids, surgery. [Verse 8] [Lead Vocalist — same melody, slightly tighter.] Acute Cervical Disk Protrusion diagnosis by M.R. or C.T. myelography. Some combination of activity restriction, immobilization, physical therapy generally prescribed. If fail, surgery [Verse 9] [Lead Vocalist — hand-muscle wasting as one falling phrase.] Cervical Rib Syndrome; compression of the C.8 to T.1. weakness and wasting of intrinsic hand muscles [Verse 10] [Lead Vocalist — antibodies given full bars; crisis colder, still sung.] Myasthenia Gravis; serum levels of Acetylcholine .Receptor antibody. "or anti M.u.S.K. for certain patients, rarely L.R.P.4 C.T. for thymoma. Treat with neostigmine, pyridostigmine; if fail; corticosteroids. If severe I.V.I.G. or plasmapheresis. Thymectomy "even in the absence of an identifiable thymoma" Myasthenic crisis; respiratory weakness, immediate admission to the I.C.U. [Verse 11] [Lead Vocalist — shorter, same tune.] Myasthenic Syndrome; Lambert-Eaton; I.V.I.G., plasmapheresis, prednisone, azathioprine [Verse 12] [Lead Vocalist — cranial list rising; autonomic list falling; reflex line almost whispered but still on pitch.] Botulism; diplopia, ptosis, facial weakness, dysphagia, and nasal speech, followed by respiratory difficulty and finally by limb weakness. Blurring of vision, mouth dryness, constipation , postural hypotension. Tendon reflexes are not affected unless the muscles are weak. Treatment with heptavalent antitoxin [Outro] [Lead Vocalist — last couplet as a quiet warning that stays on the tune.] Aminoglycosides, similar to botulism, subside rapidly if medication eliminated, Avoid in myasthenia. [Chorus] [Lead Vocalist — hook once more, lower, still fully sung.] Bell palsy, more common in pregnancy and D.M. Botulism; dry mouth, constipation Aminoglycosides, similar to botulism [Ending: Hammond chord unfinished. One guitar tremble. Bass cuts. Silence.] [End]
