Clinical Neurological Sciences (CNS)

Program Description

The Neuromuscular Clinic specializes in the diagnosis and management of patients with neuromuscular diseases. These include diseases of the anterior horn cell or motor neuron, peripheral nerves, neuromuscular junction and muscle. Specific expertise in our clinic includes the diagnosis and management of patients with diseases of:

• Peripheral nerves including hereditary neuropathies, acquired demyelinating neuropathies such as the Guillain-Barré syndrome (GBS), multifocal motor neuropathy with conduction block and chronic inflammatory demyelinating polyneuropathy (CIDP)
• Neuromuscular transmission including myasthenia gravis (MG) and the Lambert Eaton myasthenic syndrome (LEMS)
• Muscle including the inflammatory myopathies, toxic myopathies and hereditary myopathies including myotonic disorders, channelopathies and muscular dystrophies

Each of the physicians in the clinic has a specific interest in one or more of these areas. Patients are first seen in the clinic by one of the neuromuscular physicians and at follow up appointments, often by the nurse practitioner/clinical nurse specialist. Physicians and nurses in the clinic are involved in research at both a basic science and clinical level in a wide variety of neuromuscular diseases, including clinical trials of drugs and other biological treatments.

Program Offering

• Access to a variety of methods of investigating neuromuscular diseases including electrophysiological testing (EMG and NCS), nerve and muscle biopsies with neuropathological interpretation and genetic testing
• Outpatient percutaneous core muscle biopsies performed by physicians in the neuromuscular clinic (for patients seen clinically in the clinic, when appropriate)
• Open muscle and nerve biopsies performed by neurosurgeons in the Department of Clinical Neurological Sciences
• Long-term follow-up in the clinic when appropriate
• Treatment or symptom management with medications or other therapies
• Referral to physical medicine and rehabilitation specialists with expertise in neuromuscular disorders
• Referral to allied health services such as physiotherapy or occupational therapy, speech language pathology or nutritional services
• Genetic counseling
• Access to rehabilitation aids and devices (braces, etc.)
• Social services
• Education and counseling about specific diseases and their treatment

The neuromuscular clinic is closely associated with the EMG laboratory at University Campus. The EMG laboratory studies over 3000 patients a year, often for complicated disorders of peripheral nerve, neuromuscular transmission or muscle. There is also a close relationship with the ALS clinic, to which referrals of patients with motor neuron disease are often directed.

Referrals to the clinic can be made by the patient's primary physician (family doctor) or by other specialists. All referrals are screened and triaged and seen at the earliest possible opportunity depending on the urgency. In most instances referrals will be directed to the physician in the clinic most appropriate for the particular problem. Each of these physicians has a specific day(s) in the clinic.

Program Contact Information

• The Neuromuscular Clinic
  University Campus
  London Health Sciences Centre
  339 Windermere Road
  London, Ontario
  N6A 5A5
• Telephone: 519-663-3041
  Facsimile: 519-663-3328
• Office Hours are 8:00 a.m. to 4:00 p.m.
  Please leave a message on the answering machine.