Nephrogenic systemic fibrosis (NSF) is a systemic disease that affects the skin and other tissues in patients with renalinsufficiency and exposure to gadolinium-containing contrast. A 55-year-old woman with end-stage renal disease on hemodialysiswas consulted for progressive general weakness. After she had undergone multiple MRIs with gadolinium-containing contrastmedia, muscle weakness and skin lesions were developed. Her skin and muscle biopsy specimens showed CD34+ fibroblastentrapping collagen bundles. There are few reports of NSF with myopathy.

Thenar motor neuropathy (TMN) is a compressive mononeuropathy of recurrent motor branch of median nerve. It is infrequentand may have different pathogenesis. It may be a unique entity of disease or considered a variant of carpal tunnelsyndrome involving the motor branch only. We report a case of TMN induced by vigorous massage that applied strong digitalpressure in the region of the base of palm and thenar muscles.

Repetitive nerve stimulation is a simple and widely used technique to demonstrate neuromuscular transmission defect. A significant decremental response for repetitive hypoglossal nerve stimulation was obtained from the surface recordings in the tongue of a patient with dysarthria and dysphagia. Repetitive hypoglossal nerve stimulation test may be useful in diagnosis of myasthenia gravis with bulbar symptoms only. We utilized repetitive hypoglossal nerve stimulation with tongue recordings and diagnosed a case of myasthenia gravis.