The Alan and Barbara Mirken Department of Neurology treats a wide range of neuromuscular disorders (those conditions that affect the nervous system outside the brain and the spinal cord) with special expertise in amyotrophic lateral sclerosis (often referred to as ALS or Lou Gehrig’s Disease) and EMG/nerve conduction studies.

The division runs a large, weekly specialty clinic for ALS patients that is the only one in Manhattan that is co-sponsored by the New York City Chapter of the ALS Association. This multidisciplinary clinic provides a wide range of complex and coordinated care, and also supports a wealth of data that allows the department to take part in large, multi-center trials of ALS protocols, drugs and supportive care.

The division’s expertise is not at all limited to ALS. Other neuromuscular diseases and acquired conditions treated include:

• Polyneuropathies
• A wide range of neuropathies, including carpal tunnel syndrome
• Motor neuron disease
• Myasthenia gravis
• Inflammatory neuromuscular diseases like chronic inflammatory demyelinating polyneuropathy (CIDP)
• Neurological aspects of spine diseases, such as sciatica or radiculopathy
• Muscular Dystrophy
• Lambert-Eaton syndrome
• Nerve cell disorders

Diagnosing Neuromuscular Disorders
The main diagnostic test for neuromuscular disorders is a clinical evaluation. However, the department also has expertise in electrophysiological testing of muscles, nerves and their connections and nerve root function. Testing includes EMG (electromyography), nerve conduction studies and single-fiber EMG. These tests can add important information in the diagnostic understanding of a patient’s neuromuscular disorder. Further diagnostic tests may include blood tests, magnetic resonance imaging (MRI), and nerve/muscle biopsy.

Treating Neuromuscular Disorders
All methods of treating neuromuscular disorders are available and include:

• Immunosuppressive medication to modify disease progression
• Medication for symptoms and pain management
• When appropriate, inclusion in clinical trials for new medications and protocols
• Bracing to rest nerves
• Nutritional intervention when necessary
• Breathing intervention when necessary
• Physical therapy to improve and retain function
• Occupational therapy to give patients adaptive living skills
• Practical and emotional support for the patient, caregivers and family, including various support groups and input from the department’s social worker
• Collaborative psychological and psychiatric counseling and evaluation, when necessary, to help patients with co-existing conditions (depression, anxiety) that can accompany neuromuscular disorders
• Referrals to other medical disciplines as needed (surgeons, for example)
• Ongoing care and follow-up. In fact, because of the chronic condition of neuromuscular disorders, the department attentively follows some patients for decades.

More about neuromuscular disorders
View Neuromuscular and ALS Physicians