Services

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

The Autonomic Disorders Clinic

is under the direction of Chafic Karam, M.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 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 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 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 Peripheral Neuropathy Clinic

is under the direction of Chafik Karam, MD 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 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  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.