Neuromuscular disorders include a wide-range of diseases affecting the peripheral nervous system, which consists of all the motor and sensory nerves that connect the brain and spinal cord to the rest of the body. Progressive muscle weakness is the predominant condition of these disorders. At the University of Michigan Neuromuscular Program, we have expertise in evaluating and comprehensively treating neuromuscular disorders. We are an academic, tertiary care center with a dedicated program and specialists, allowing us to be on the cutting edge of new information and treatment options. Many of these disorders are treatable if the treatment is initiated early and appropriately. In fact, further disability can be stopped and potentially reversed. Finding out the exact nature of the disorder will also allow you to understand all the implications of your disease and, if it’s hereditary, what it might mean for your family and offspring. We treat the full scope of neuromuscular disorders, including:
- Diabetic neuropathy – nerve damage caused by diabetes
- Amyotrophic lateral sclerosis (Lou Gehrig’s Disease) and other motor neuron diseases – destroys cells that control voluntary muscle activity
- Toxic neuropathy – pain and weakness caused by toxic substances
- Small fiber neuropathy – affects the nerve endings of the skin
- Autonomic neuropathies – damage to nerves that affects the heart, blood pressure, body temperature, digestion and more
- Muscular disorders, hereditary:
- Congenital myopathies – muscle weakness existing at birth
- Muscular dystrophy – a group of disorders involving muscle weakness
- Metabolic myopathies – breakdown of muscles, cramping syndromes, exercise intolerance, including mitochondrial disorders
- Muscular disorders, acquired:
- Inclusion body myositis – inflammatory muscle disease includes weakness and difficulty swallowing
- Dermatomyositis – inflammatory muscle disease includes muscle weakness and skin rash
- Polymyositis – includes muscle weakness and inflammation
- Necrotizing myopathy – extensive muscle destruction
- Neuromuscular junction disorders (dysfunction at location where nerves connect with muscles):
- Myasthenia gravis – communication problem between nerves and muscles results in muscle weakness and muscle fatigue
- Lambert-Eaton Syndrome – often coincides with cancer, causing muscle weakness
To help us determine the best treatment, you will have an electrodiagnostic appointment at our Electroneuromyography Laboratory. During this appointment, small electrical impulses are applied to your nerves and electrical responses are recorded. This lets us see if you have loss of nerve fibers or a problem with the wrapping (insulation) of the nerves. We also insert a small acupuncture-size needle into the muscles to listen to neuroactivity and determine if there is a primary muscle disorder. Many other tests can also be conducted here, as needed, including repetitive stimulation studies for the neuromuscular junction, autonomic nerve testing and single fiber EMG for assessing transmission at the neuromuscular junction. Many of these specialized studies can only be performed at a center of our size with dedicated technicians able to properly interpret the studies. We also perform our own muscle and skin biopsies at our clinic. Treatment varies widely, depending on your diagnosis and other factors. Some treatment options include medical therapy, including immunosuppressive drugs, pain management and assistive devices. We also offer apheresis, which filters out antibodies in the blood associated with neuromuscular disease that causes weakness and other problems. This can allow us to get ahead of some diseases and treat them more effectively. We are one of only a few centers in the country to provide this service. Clinical trials offering the newest therapies are also available to our patients. We collaborate with a number of disciplines to best treat each patient, including rheumatology, physical medicine and rehabilitation, endocrinology, podiatry, infectious disease and neurosurgery. We are an ALS Association Certified Center – one of only two in the state –providing comprehensive care to patients with all forms of motor neuron disease, including amyotrophic lateral sclerosis (ALS). New patient referrals are first seen in the Neuromuscular Disorders Clinic prior to continuing their care in the Motor Neuron Disease Center.
In order to provide excellence in treatment and research, we have two other centers to target specific neuromuscular conditions:
Motor Neuron Disease/ALS Center
Provides information about the clinical and research efforts underway for ALS/motor neuron disease patients in Michigan.
U-M Peripheral Neuropathy Center
Provides information about the multidisciplinary approach to the diagnosis and treatment of disorders of the peripheral nerves and muscles.