Neuromuscular Disorders

UT Southwestern Medical Center’s neuromuscular specialists are experts in the diagnosis and treatment of neuromuscular disorders, and we’re active in research to develop new therapies. Our large team of physicians is board-certified in both neurology and neuromuscular medicine and supported in our clinics by experienced nurses and nurse practitioners.

While we treat all neuromuscular disorders, our group has particular expertise in amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), myasthenia gravis, myotonic and muscular dystrophies, immune-mediated neuropathies, and autonomic disorders. 

Comprehensive Care for Neuromuscular Conditions

Neuromuscular disorders are problems with the functions of the nerves and muscles.  Typical symptoms of these disorders are weakness and changes in sensation.

UT Southwestern’s physicians take advantage of the latest treatments for neuromuscular disorders, which build on the groundbreaking research conducted here.

Our patients have access to a multidisciplinary team of health care providers and a complete array of neurodiagnostic tests, such as electromyography; autonomic testing; and skin, nerve, and muscle biopsy. Through our expert use of these and other assessments, we provide the most accurate diagnoses and compassionate, effective care.

Our clinical practices are partially sponsored by the Muscular Dystrophy Association (MDA) and are recognized by the Myasthenia Gravis Foundation of America, the Neuropathy Association, and the GBS/CIDP Foundation International. 

Symptoms

Symptoms can vary from mild to debilitating and are sometimes progressive. They include:

• Pain
  
• Weakness
  
• Numbness
  
• Muscle cramps
  
• Lightheadedness
  
• Muscle atrophy
  
• Breathing difficulty

Conditions

Common neuromuscular diseases treated at UT Southwestern include: 

Amyotrophic lateral sclerosis (ALS)

Often called “Lou Gehrig’s disease,” ALS is one of the more common neuromuscular disorders. More than 5,600 people are diagnosed with ALS in the U.S. each year. The disease involves a breakdown of motor neurons that work to control voluntary muscle movements. While there is no cure for ALS, UT Southwestern physicians provide the latest therapies and treatments that can help slow the disease’s progress and manage its symptoms. 

Autonomic disorders

This diverse group of diseases affects the automatic functions of the body. When the autonomic nervous system is not working properly, patients can develop a number of symptoms such as lightheadedness and fainting, inability to sweat, constipation, bladder problems, and dry mouth. These disorders can be diagnosed with testing that is available only at specialized centers like UT Southwestern, where our physicians provide effective treatment. 

Muscular dystrophies (MD)

MD is a group of more than 30 disorders that cause progressive weakness of muscles. While no treatment for reversing the effects of these disorders exists, UT Southwestern physicians can provide several treatments and therapies for improving a patient’s outlook. Our patients can also benefit from multispecialty care supported by MDA. When needed, this care includes evaluation by heart and lung doctors as well as physical therapy and recommendations for assistive devices. 

Myasthenia gravis (MG)

MG is an autoimmune disease that causes muscle weakness and fatigue by interrupting communication between nerve impulses and muscles; it affects approximately 37,000 people in the U.S. Treatments for myasthenia gravis include surgical options and medications to improve nerve transmission. Neurologists at UT Southwestern are recognized experts in the diagnosis and treatment of MG and are involved in clinical research studies to evaluate new therapies. 

Peripheral neuropathies (PN)

These disorders cause damage to nerve fibers. Common symptoms of PN include numbness of the feet and fingers, weakness, and unsteadiness. Neurologists in the Neuromuscular Disorders Clinic are experts at identifying the cause of PN and recommending effective treatment.

In addition to these conditions, the specialists in the UT Southwestern Neuromuscular Disorders Clinic also treat inflammatory neuropathies (such as Guillain-Barre syndrome; chronic inflammatory demyelinating polyradiculoneuropathy, or CIDP; and others), inflammatory and metabolic myopathies, motor neuron diseases, stiff person syndrome, peripheral neuropathy, inflammatory myopathy, dysautonomia, and many other disorders.

Testing and Treatment Options

UT Southwestern provides routine and advanced diagnostic services to diagnose neuromuscular disorders; these include:

• Nerve conduction studies
  
• Routine and single fiber electromyography
  
• Quantitative sensory testing (QST) evoked potentials
  
• Quantitative autonomic testing, known as autonomic reflex screen (ARS)
  
• Skin biopsy for determination of small fiber nerve density
  
• Muscle biopsy
  
• Genetic testing
  
• Antibody testing for autoimmune neuromuscular condition
  

Our specialists identify how patients’ neuromuscular and neurological conditions are related, enabling us to precisely tailor the treatments to the conditions.

While not all neuromuscular disorders have specific therapies available, a number of these diseases can be treated, often with a variety of immunosuppressive medications. We also offer an infusion clinic and plasma exchange service for patients with immune-mediated disorders.

Patients receive care from a complete team – neurologists, physical therapists, speech pathologists, respiratory therapists, pulmonologists, psychologists, dietitians, and social workers. These specialists help patients access all needed therapies and rehabilitation services to improve symptoms, increase mobility, and lengthen life.

Rehabilitation

Whether symptoms are mild or severe, anyone with neuromuscular disorders can benefit from neurological rehabilitation at UT Southwestern.

Our multidisciplinary team approach to rehabilitation is designed to address the physical and psychological management of the condition. Our rehabilitation team includes physicians; nurses; neuropsychologists; psychologists; and occupational, physical, recreational, vocational, and speech therapists. 

The UT Southwestern rehabilitation program strives to help patients find ways to participate in activities at work, at home, and in the community.

Clinical Trials and Ongoing Research

Our physicians and scientists are involved in a number of research and therapy studies, such as treatment and pathophysiological studies for ALS, peripheral neuropathies, autonomic failure, myotonic disorders, and others.

Steven Vernino, M.D., Ph.D., conducts therapeutic trials for autonomic disorders such as multiple system atrophy, autoimmune autonomic ganglionopathy, and orthostatic hypotension in patients with Parkinson's disease.

Jaya Trivedi, M.D., continues to recruit patients into a number of NIH-supported studies investigating electrophysiological and clinical aspects of nondystrophic myotonia and periodic paralysis.