Neuromuscular Division

Welcome to the Neuromuscular Division at Mass General. This site is designed to provide you with up-to-date information about our division and the services we offer, including clinical care, education and research related to disorders of the nerve, muscle, neuromuscular junction and anterior horn cell. The Neuromuscular Division offers expertise in a wide range of acquired, autoimmune and inherited conditions, with an emphasis on diagnosis, treatment and research. We hope that this site provides you with the answers and support you are searching for in relation to these disorders. It is our pleasure to serve you.

Sincerely,
Amanda C Guidon, MD, MPH
Chief, Neuromuscular Division
Department of Neurology

Division Overview

The Neuromuscular Division at Mass General provides comprehensive neurological evaluations, including electrophysiological testing, muscle biopsy, autonomic function testing, nerve ultrasound, skin biopsy, speech and swallow evaluations, genetic counseling, nutritional counseling and physical, occupational and speech therapies. Our Neuromuscular specialists care for patients with a variety of acquired, autoimmune and inherited disorders of the nerve (neuropathies), muscle (myopathies), neuromuscular junction (myasthenia gravis) and anterior horn cell (amyotrophic lateral sclerosis). In addition to our general neuromuscular clinics, several disease-specific subspecialty clinics and programs are offered, including Inherited Neuropathies (CMT), Myasthenia Gravis, Acquired and Hereditary Muscle disorders (myopathies), Myotonic Dystrophy, Pediatric Neuromuscular Disorders and ALS/MND.

The Adult Neuromuscular Service also interacts closely and with Neurological Clinical Research Institute, the Consortium for Rare Disorders, the Nerve Injury Unit and the Neurogenetics Unit at Mass General.

Several clinics offer multidisciplinary care, with onsite participation by physical medicine and rehabilitation physicians, allied health providers from nursing, physical, occupational, respiratory and speech therapy, genetic counselors, orthotics specialists and research coordinators. The clinics are closely affiliated with related specialists in cardiology, pulmonology and surgery.

Our physicians have specialized expertise in the diagnosis and treatment of a wide range of neuromuscular disorders, including:

• Myopathies (muscle diseases) such as muscular dystrophy, myotonic dystrophy and myositis
• Neuromuscular junction disorders such as myasthenia gravis
• Nerve disorders such as Guillain-Barré Syndrome, Charcot-Marie-Tooth Disease, Chronic inflammatory Demyelinating Polyneuropathy (CIDP) and neuropathies related to other general diseases such as diabetes
• Motor neuron disorders such as amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy

The Neuromuscular Diagnostic Center & EMG Laboratory

The Neuromuscular Diagnostic Center is a state-of-the-art center that provides comprehensive care for patients, housing three outpatient exam rooms and seven electromyography (EMG) and autonomic testing procedures. The center provides outpatient consultation and diagnostic services as well as treatment and ongoing care.

Additional specialty services include single fiber EMG, EMG-guided botulinum toxin injections, nerve and muscle biopsy, nerve ultrasound and forearm exercise testing.

Research

The Neuromuscular Division maintains active research programs in both the basic and clinical neurosciences. The faculty members in the neuromuscular division have a deep clinical expertise in a wide range of neuromuscular diseases. These specialists work closely with a large roster of basic and translational scientists investigating disease mechanisms, discovering potential biomarkers, identifying disease targets and developing new therapeutic treatments.

Comprehensive Care

In the Neuromuscular Division, patients with neuromuscular disorders receive comprehensive diagnostic and treatment services in a single location. The Neuromuscular Division comprises several entities:

Outpatient Neuromuscular Clinics: A team of clinicians provides expert diagnostic and treatment services including access to innovative research studies and therapeutic trials. A wide range of general and subspecialty neuromuscular clinics offer comprehensive care to both adult and pediatric patients. We are associated with the Muscular Dystrophy Association (MDA), the Myasthenia Gravis Foundation of America (MGFA) and the Charcot Marie Tooth Association (CMTA).

• Myopathy Clinic
• Charcot Marie Tooth Center of Excellence
• Myasthenia Gravis Center
• Pediatric Neuromuscular Clinic: Neurologists at this clinic, which falls under the administration of Mass General for Children, work closely with other Mass General neurologists with special training and interest in pediatrics
• ALS Multidisciplinary Clinic: This clinic provides high-quality care along with access to the latest treatments and research opportunities
• Botulinum Toxin Service: Botulinum toxin treatments are available to treat dystonia, spasticity (due to stroke, head injury or multiple sclerosis) and various other disorders like excessive drooling or sweating
• Genetic testing

Neuromuscular Diagnostic Center: Established in 2006, the Neuromuscular Diagnostic Center includes:

• Electromyography (EMG) Laboratory: Board-certified electromyographers specialize in diagnosing muscle and nerve disorders
• Autonomic Laboratory: This facility employs tilt-table testing, quantitative sweat testing and other maneuvers for the evaluation of patients with autonomic disorders, syncope and small-fiber neuropathy

• Muscle Biopsy Service for the diagnosis of a wide range of muscle disorders
• Forearm exercise testing to diagnose metabolic myopathies