Several sub-specialty clinics exist to address the needs of patients with neuromuscular disease. Patients are seen at the UNC Neurology outpatient clinics and in the EMG laboratory. Telemedicine appointments are also currently available.
The Muscular Dystrophy Association Clinic
The Muscular Dystrophy Association (MDA) Clinic meets several times weekly and is under the direction of Rebecca Traub, MD. These clinics provide comprehensive diagnostic evaluation, consultation, treatment and management to adults and children with a variety of neuromuscular diseases. 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
The Myasthenia Gravis Clinic was founded by James F. Howard, Jr., MD, in 1979 with the mission to offer comprehensive diagnostic evaluation, consultation, treatment and management for patients with myasthenia gravis from around the world. Dr. Howard currently runs the Myasthenia Gravis Clinical Trials Program dedicated to bringing novel therapeutic drugs to the bedside for patients with myasthenia gravis.
Patients seen in the Myasthenia Gravis Clinic are cared for by a team of neuromuscular medicine providers, including Drs. Anahit Mehrabyan, Rebecca Traub and Jorge Almodovar Suarez. The clinic offers additional care with Stephanie Iyer, CPP (pharmacist), and Alexandra Rojo, RN (neuromuscular nurse).
Patients undergoing electrodiagnostic testing in the evaluation and treatment of myasthenia gravis are seen in the UNC Neurophysiology Lab, and Dr. Howard continues to perform single fiber electromyography.
The providers in the Myasthenia Gravis Clinic work closely with other specialists and services at UNC including infusion services, plasma exchange, and rehab specialists.
The Myopathy Clinic
The Myopathy Clinic, under the direction of Anahit Mehrabyan, MD, 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 and congenital myopathies
- Metabolic and toxic myopathies, and
- Inflammatory and autoimmune myopathies.
Myopathy patients seen at UNC undergo comprehensive clinical, electrodiagnostic, genetic and pathologic evaluation. New patient evaluations offer include full-day evaluation and testing to serve patients travelling from all parts of the North Carolina and the surrounding region. Follow up clinical care is often coordinated with multidisciplinary clinics, including rehabilitation therapies and orthotics.
The Peripheral Neuropathy Clinic
The Peripheral Neuropathy Clinic, under the direction of Rebecca Traub, MD, 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 UNC peripheral neuropathy clinic has been designated as a Charcot-Marie-Tooth Association (CMTA) Center of Excellence and a Hereditary Neuropathy Foundation (HNF) Center of Excellence for treating patients with inherited neuropathies and offering research study participation.
The Peripheral Neuropathy Clinic also participates in the UNC interdisciplinary amyloidosis program, collaborating with specialists in oncology, cardiology and nephrology to treat patients with inherited and acquired amyloidosis.
The Amyotrophic Lateral Sclerosis (ALS) Clinic
The ALS clinic, under the direction of Drs. Deborah Gelinas and Jorge Almodovar, offers multidisciplinary patient care to patients with ALS and related motor neuron disorders. Patients are seen by a team of specialists, including an ALS-specialized neurologist, physical and occupational therapist, social worker, respiratory therapist, nutritionist and others.
The Clinical Neurophysiology (CNP) Laboratory
The Clinical Neurophysiology 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 skin biopsy for small fiber neuropathy. In addition, other sections of the CNP Laboratory provide expertise in EEG (electroencephalography), video-EEG, ambulatory EEG monitoring, evoked potential studies and sleep studies.