Practical application of electron microscopy to neuromuscular diseases

Concerning individual neuromuscular conditions, electron microscopy may be considered "essential," "helpful," or "wasteful." "Essential" electron microscopy should provide a clear diagnosis, because of the disease specificity of the ultrastructural findings, in particular as to inclusions within muscle fibers, such as cylindrical spirals and reducing bodies. Electron microscopy may be "helpful" in detecting ultrastructural features preceding typical light microscopic findings, for instance, undulating tubules in endothelial cells. Congenital, metabolic, and inflammatory myopathies may often be more easily and more reliably diagnosed by means of the electron microscope. Diagnostically "wasteful" electron microscopy may pertain to muscular dystrophies, neurogenic atrophy, and myotonic diseases.