Muscle biopsy is usually considered when a neonate presents with unexplained muscle weakness, hypotonia, or other symptoms suggestive of a neuromuscular disorder that cannot be diagnosed through less invasive methods. It is often part of a broader diagnostic workup that may include blood tests, electromyography (EMG), and genetic testing. The decision to proceed with a muscle biopsy is typically made by a team of specialists, including pediatric neurologists and geneticists.