Neuromuscular Diseases

The Neuro-Muscular Section Head is Alan Pestronk, M.D.

Visit the Neuromuscular website here: neuromuscular.wustl.edu

The Neuromuscular Clinic sees over 2,000 outpatients a year. Specific diseases treated include: ALS-Lou Gehrig's Disease, muscle disorders, including muscular dystrophy and myositis, nerve disorders, including peripheral neuropathies and pain, and myasthenia gravis. Most other patients have disorders of muscles or peripheral nerves and some have ataxia and spinal cord disorders.

Because of the interrelatedness of all these neuromuscular diseases, the Neuromuscular Clinic is supported by the Muscular Dystrophy Association (MDA), and is a designated ALS/MDA clinic. We provide a full range of services, including electrodiagnostic testing, medical, physical, and occupational therapy, as well as respiratory and nutritional care. Patients may also receive orthotics, social work services, medical and rehabilitation supplies, and wheelchair evaluations.

FOR AN APPOINTMENT CALL: (314) 362-6981

Patients must be referred by their attending physician or another neurologist, and are seen at the Center for Advanced Medicine (Forest Park & Euclid), 6th Floor. Parking is in the North Garage on Euclid Avenue. The neuromuscular consultants include seven full-time faculty physicians. New patients will be assigned a physician. After the initial visit, they may continue to see the same physician.

New patients - What to Expect
Prior to receiving an appointment, the referring physician should send or fax medical records to our offices. Those records should include:

A diagnosis or reason for referral
Recent history and physical exam by a neurologist
Insurance information
Contact information for the referring physician for sending our reports.

NEUROMUSCULAR CLINICAL SERVICES
ALS-Lou Gehrig's Disease
Amyotrophic lateral sclerosis (ALS), often referred to as "Lou Gehrig's disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Approximately 5,600 people in the U.S. are diagnosed with ALS each year and it is estimated that as many as 30,000 Americans may have the disease at any given time.

Although the life expectancy of an ALS patient averages about two to five years from the time of diagnosis, many people live with quality for five years and more. About twenty percent of people with ALS live five years or more, and five percent will live 20 years. There are people in whom ALS has stopped progressing and a small number of people in whom the symptoms of ALS reversed. ALS occurs throughout the world with no racial, ethnic or socioeconomic boundaries. It can strike anyone.

Muscular Dystrophy
The muscular dystrophies (MD) are a group of more than 30 genetic diseases characterized by progressive weakness and degeneration of the skeletal muscles that control movement. Some forms of MD are seen in infancy or childhood, while others may not appear until middle age or later. The disorders differ in terms of the distribution and extent of muscle weakness (some forms of MD also affect cardiac muscle), age of onset, rate of progression, and pattern of inheritance.

Myasthenia Gravis
Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the voluntary muscles of the body, usually during activity. It improves with rest. With current therapies, for the majority of individuals with myasthenia gravis, life expectancy is normal. Muscles often but not always affected include those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing; and sometimes those that control breathing and neck and limb movements.

The Muscular Dystrophy Association supports services and research, not only for the muscular dystrophies, but for related diseases, including motor neuron diseases such as ALS, metabolic diseases of the muscle, diseases of peripheral nerves, and myopathies, such as Myasthenia Gravis.

Electrodiagnostic (EMG) Testing
Our active electrodiagnostic service studies 2,500 patients a year. Tests include:
Electromyography
Nerve conduction studies
Repetitive nerve stimulation
Single-fiber EMG
Quantitative sensory evaluation
Autonomic testing
In addition to seeing patients, the Neuromuscular Division provides key laboratory services for patient diagnosis and for outside physicians to help in their diagnoses. The Neuromuscular Clinical Laboratory provides antibody testing and neuromuscular pathology services.

Antibody Testing
A wide range of antibody testing is performed by researchers. Physicians may go to the link above to receive complete information on testing performed, instructions for submitting the tests, and forms that must accompany samples.

Neuromuscular Pathology
This service conducts muscle and nerve biopsies, over 500 muscle and 100 nerve biopsies a year. Tests performed include histology, muscular dystrophy testing, myositis testing, and mitrochondrial testing.