Neuromuscular Disorders

The Neuromuscular Disorders Section of the Department of Neurology includes sub-specialty clinics, the Electromyography Section of the Clinical Neurophysiology Laboratory, the Neuromuscular Consultation Service, Muscle Biopsy Service and the Neuromuscular Research Unit.

Mission

The mission of the Neuromuscular Disorders Section is to provide high quality comprehensive neuromuscular care to our patients, to provide top-tier educational programs for physicians-in-training and to build research programs dedicated to the prevention and treatment of neuromuscular disorders.

Programs

The Neuromuscular Disorders Section of the Department of Neurology includes sub-specialty clinics, the Electromyography Section of the Clinical Neurophysiology Laboratory, the Neuromuscular Consultation Service and the Muscle Biopsy Service. The Neuromuscular Group deals with the diagnosis and treatment of diseases of the motor neuron, plexus, peripheral nerve the autonomic nervous system, neuromuscular junction and muscle. The Neuromuscular Disorders Section includes some of the nation's most respected neuromuscular experts.

Several sub-specialty clinics exist to address the needs of patients with neuromuscular disease.

The Autonomic Disorders Clinic

is under the direction of Caroline M. Klein, M.D., Ph.D. The Autonomic Function Group is a unique resource for comprehensive diagnostic evaluation, consultation, treatment and management and care of patients with disorders affecting the autonomic nervous system. These disorders include multiple system atrophy, pure autonomic failure, orthostatic hypotension, postural orthostatic tachycardia syndrome (POTS), orthostatic intolerance, fainting, and abnormalities of sweating. Clinical evaluation takes advantage of the techniques available for neuromuscular disorders as well as specialized tests of autonomic function available in the Autonomic Function Laboratory

The Chemodenervation (Botulinum Toxin) Clinic

began in 1989. The neurologists have extensive experience with treating a wide range of conditions with botulinum toxin, in particular, blepharospasm, cervical dystonia, hemifacial spasm, laryngeal dystonia (with our ENT colleagues) and childhood spasticity.

The Dystrophinopathy Team

is a multidisciplinary program involving members of the Department of Neurology (Drs. Howard, Weig, Fan), the Gene Therapy Center (Dr. Samulski), the Division of Molecular Pharmaceutics (Dr. Xiao) of the School of Pharmacy, the Magnetic Resonance Imaging Research Center (Dr. Lin) of the Department of Radiology and the newly formed Canine Laboratory Facility (Dr. Kornegay) of the Department of Pathology and Laboratory Medicine. The mission of this group is to develop clinical gene therapy trials for the treatment of Duchenne muscular dystrophy and to identify surrogate markers that can be used to assess changes in disease severity during these trials.

The Muscular Dystrophy Association Clinic

sponsored by the Muscular Dystrophy Association meets several times weekly and is under the direction of James F. Howard, Jr., M.D. and Spencer G. Weig, M.D. These clinics provide adults and children with a variety of neuromuscular diseases comprehensive diagnostic evaluation, consultation, treatment and management. Some of the diseases followed in this clinic include muscular dystrophy in adults and children (Duchenne's, Becker’s, Myotonic, Limb-Girdle, FSH), inflammatory myopathies (polymyositis, dermatomyositis, inclusion body myositis), metabolic and mitochondrial myopathies, disease of neuromuscular transmission (Myasthenia Gravis, Lambert-Eaton syndrome), congenital myopathies, hereditary peripheral neuropathies (Charcot-Marie-Tooth disease), and motor neuron disease (Amyotrophic Lateral Sclerosis [ALS], spinal muscular atrophy [SMA])

The Myasthenia Gravis Clinic

is under the direction of James F. Howard, Jr., M.D. The Myasthenia Gravis Clinic offers comprehensive diagnostic evaluation, consultation, treatment and management for patients with myasthenia gravis from around the world. Dr. Howard also carries out clinical and laboratory-based research on the causes, diagnosis and treatment of myasthenia gravis. In addition to providing personal, expert care to patients, he serves as an advisor to national organizations interested in myasthenia gravis, including the Myasthenia Gravis Foundation of America and the Muscular Dystrophy Association.

The Peripheral Neuropathy Clinic

is under the direction of Caroline M. Klein, M.D., Ph.D. This clinic provides for the comprehensive diagnostic evaluation, consultation, treatment and management of patients with a variety of peripheral neuropathies. Some of the diseases followed in this clinic include hereditary neuropathies (such as Charcot-Marie-Tooth Disease), diabetic neuropathy, amyloid neuropathy, chronic inflammatory demyelinating neuropathy (CIDP), small fiber sensory neuropathies and vasculitic neuropathies.

The Clinical Neurophysiology (CNP) Laboratory

at UNC Hospitals is a multi-disciplinary laboratory providing state of the art expertise in the diagnostic evaluation and physiological characterization of all nervous system disorders. Several Sections are present within the laboratory. The Neuromuscular Section performs Autonomic Function studies, EMG-NCS (electromyography-nerve conduction studies), neurography, quantitative EMG studies, single fiber EMG and Quantitative Sensory Testing. Approximately 1600 patient studies are performed yearly. In addition, other sections of the CNP Laboratory provide expertise in EEG (electroencephalography), video-EEG and ambulatory EEG monitoring, evoked potential studies and sleep studies.

The Myopathy Clinic

is under the direction of Nizar Chahin, M.D. This clinic provides for the comprehensive diagnostic evaluation, consultation, treatment and management of patients with a variety of muscle disorders. Some of the diseases followed in this clinic include muscular dystrophies, metabolic and toxic myopathies and inflammatory myopathies.

The Muscle-Nerve Biopsy Service

provides biopsy service for adults and older children on an outpatient basis and is run jointly with the Department of Pathology. Biopsies are performed by Ajmal M. Gilani, M.D. on a weekly basis. Interpretation and review of biopsy specimens occurs at weekly conferences with Nizar Chahin, M.D. and members of the Department of Pathology. Muscle histochemistry and immunocytochemical staining is performed as well as electron-microscopic evaluation of the specimens. Approximately 100 muscle and peripheral nerve biopsies are performed yearly.

An active didactic program is available to residents and fellows and involves weekly conferences in neuromuscular diseases, electromyography / electrodiagnosis, and peripheral nerve / muscle pathology. Residents and fellows are encouraged to participate in ongoing clinical research, including treatment trials for a number of neuromuscular disorders.

The Neuromuscular Disorders Section offers one or two year fellowships which include comprehensive training in clinical neuromuscular disease and clinical neurophysiology of the peripheral nervous system (EMG) that meets the training requirements for the American Board of Electrodiagnostic Medicine.

Faculty and Staff

Thomas G. Braun, M.D. is Clinical Associate Professor of Neurology. Dr. Braun received his neurological training at the University of Michigan (Ann Arbor) and his Neuromuscular and EMG Fellowship at The University of North Carolina at Chapel Hill. Dr. Braun is Board Certified in Neurology and the American Board of Electrodiagnostic Medicine and is a current member of the American Academy of Neurology and the American Association of Neuromuscular and Electrodiagnostic Medicine.

Nizar Chahin, M.D. is Assistant Professor of Neurology.  Dr. Chahin received his neurological training at the University of Missouri.  He has completed 3 fellowships, in Peripheral Nerve Disease, EMG, and Neuromuscular Disease at Mayo Clinic in Rochester, Minnesota.  Dr. Chahin is Board Certified in Neurology and is a current member of the American Academy of Neurology.

 Zheng (Jane) Fan, M.D. is Adjunct Assistant Professor of Neurology and Pediatrics. Dr. Fan received her pediatric and neurological training at The University of North Carolina at Chapel Hill and her Medical Genetics Fellowship at the same institution. Dr. Fan is Board Certified in Neurology with Special Qualifications in Child Neurology and  medical Genetics. She is a current member of the American Academy of Neurology and the American College of Medical Genetics

Ajmal M. Gilani, M.D. is Clinical Assistant Professor of Neurology. Dr. Gilani received his neurological training at The University of North Carolina at Chapel Hill and his Neuromuscular and EMG Fellowship at the same institution. Dr. Gilani is Board Certified in Neurology and is a current member of the American Academy of Neurology and the American Association of Neuromuscular and Electrodiagnostic Medicine.

Colin D. Hall, MBChB is Professor of Neurology and Medicine.  Dr. Hall received his neurological training at The University of North Carolina at Chapel Hill and fellowship training in muscle biopsy and muscle histopathology with Sir John Walton at the University of Newcastle upon Tyne. He has an international reputation in the neurology and neuromuscular effects of HIV disease. Dr. Hall is Board Certified in Neurology and the American Board of Electrodiagnostic Medicine and is a current member of the American Neurological Association, American Academy of Neurology and the American Association of Neuromuscular and Electrodiagnostic Medicine.

James F. Howard, Jr., M.D. is the James F. Howard Distinguished Professor of Neuromuscular Disease, Professor of Neurology and Medicine and Chief of the Neuromuscular Disorders Section. Dr. Howard received his neurological training at the University of Virginia in Charlottesville and his Neuromuscular-EMG Fellowship at the same institution. He has an international reputation in Myasthenia Gravis and quantitative EMG techniques. Dr. Howard is Board Certified in Neurology and the American Board of Electrodiagnostic Medicine and is a current member of the American Neurological Association, American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, New York Academy of Sciences and the Society for Neuroscience.

Kimberly M. Johnson, MSW LCSW CCM is our Clinical Social Worker. Ms. Johnson received her social work training at East Carolina University and her Masters degree at the same institution. She has extensive experience assisting patients with neuromuscular disorders in navigating the intricacies of health care systems and providing psycho-social support and assistance. Ms. Johnson is a Licensed Clinical Social Worker, Clinical Care Manager and a current member of the Carolinas Chapter of the Myasthenia Gravis Foundation, serving on their Board of Directors.

Caroline M. Klein, M.D., Ph.D. is Assistant Professor of Neurology. Dr. Klein received her neurological training at the University of Virginia. She has completed 3 fellowships, in Peripheral Nerve Disease, EMG, and Clinical Autonomic Research at Mayo Clinic in Rochester, Minnesota. Dr. Klein is Board Certified in Neurology with Added Qualifications in Clinical Neurophysiology and is a current member of the Peripheral Nerve Society, American Autonomic Society, American Academy of Neurology and the American Association of Neuromuscular and Electrodiagnostic Medicine.

Spencer G. Weig, M.D. is Professor of Neurology (Child Neurology Section). Dr. Weig received his neurological training at the University of North Carolina at Chapel Hill. He received his fellowship training at the University of Massachusetts in clinical neurophysiology. Dr. Weig is Board Certified in Pediatrics and Neurology with Special Qualifications in Child Neurology and Added Qualifications in Clinical Neurophysiology and is a current member of the American Academy of Neurology, the Child Neurology Society and the American Academy of Pediatrics.

Referrals, Questions and Additional Information Neuromuscular Consultations and referrals may be easily arranged by physicians or their offices and health care agencies by contacting:

By mail:

Appointment Secretary Neuromuscular Disorders Section
University of North Carolina
Department of Neurology
170 Manning Dr. CB#7025
Chapel Hill, NC 27599-7025

By phone:

919.966.5522 and speak with the Neuromuscular Secretary

By fax:

919.966.2922

Electrodiagnostic Studies (EMG, neurography, quantitative EMG, single fiber EMG, quantitative sensory testing (QST)) and Autonomic Function Testing may be easily arranged by physicians or their offices and health care agencies by contacting the Clinical Neurophysiology Laboratory at UNC Hospitals

By phone: 919.966.1686 
By fax: 919.966.4278

Muscle and peripheral nerve biopsies may be easily arranged by physicians or their offices by contacting the secretary of the Muscle Biopsy Service at:

By phone: 919.966.5522 
By fax: 919.966.2922