Division of Neuromuscular Medicine

The Montefiore Einstein Division of Neuromuscular Medicine and Muscular Dystrophy Association Center were among the first of their kind in the nation to treat the full spectrum of neuromuscular diseases occurring from early infancy through late adulthood. We specialize in disorders of the peripheral nerves, muscles, and neuromuscular junctions, including traumatic nerve injury; peripheral and toxic neuropathies; motor neuron disorders, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease); neuromuscular junction disorders, such as myasthenia gravis; all forms of muscular dystrophy, mitochondrial and encephalopathies; as well as many additional rare and complex conditions.

The Saul R. Korey Department of Neurology defined the field of neurotoxicology, including the classification of a broad spectrum of unique neurological disorders. We also established the biological underpinnings of many of these disorders and were the leading international experts in investigating and uncovering the consequences of major industrial accidents and other environmental influences on neurologic disabilities.

We are an internationally recognized leader in the field of neuromuscular medicine, dedicated to advanced clinical evaluation, interdisciplinary care and research of neuromuscular disorders. We are ranked in the top 1% of all hospitals in the nation for neurology, according to U.S. News & World Report, and have one of the best residency and fellowship training programs worldwide. 

Our world-renowned experts utilize the latest, revolutionary advances in gene therapy and other state-of-the-art therapeutic approaches to optimize neurological function and quality of life, including enabling floppy babies to take their first steps.
 

We specialize in the often challenging process of evaluating unexplained and debilitating nerve and muscle pain and weakness, combining clinical expertise with the latest technological techniques, including advanced electrodiagnostic, neuroimaging and neuropathologic testing.

We provide treatment that can include the following:

• Medications
• Infusion therapy (intravenous immunoglobulins)
• Plasmapheresis
• EMG, or ultrasound-guided chemo-denervation with botulinum toxin (Botox)
• Physical and occupational therapy
• Genetic counseling
• Surgery

Neuromuscular disorders are a group of diseases that affect the peripheral nervous system. The motor and sensory nerves that connect the spinal cord and the brain to the rest of the body make up the peripheral nervous system, and neuromuscular disorders present symptomatically as progressive muscle weakness.

Myasthenia gravis is the most common neuromuscular disease. It is a chronic autoimmune disorder that causes weakness in the skeletal muscles (the muscles that connect to your bones, contract to allow body movement in the arms and legs and allow for breathing).

The hallmark of myasthenia gravis is muscle weakness that worsens after periods of activity and improves after periods of rest. Certain muscles are often (but not always) involved in the disorder, such as those that control:

• Eye and eyelid movement
• Facial expressions
• Chewing
• Talking
• Swallowing

The onset of the disorder may be sudden, and symptoms may not be immediately recognized as myasthenia gravis. The degree of muscle weakness involved varies greatly among individuals.
 

Another common neuromuscular disease is muscular dystrophy (MD). MD refers to a group of more than 30 genetic diseases that cause progressive weakness and degeneration of skeletal muscles used during voluntary movement. These disorders vary in age of onset, severity and pattern of affected muscles. All forms of MD grow worse as muscles progressively degenerate and weaken. Many individuals eventually lose the ability to walk.

Some types of MD also affect the following:

• Heart
• Gastrointestinal system
• Endocrine glands
• Spine
• Eyes
• Brain
• Other organs

Respiratory and cardiac diseases may occur, and some people may develop a swallowing disorder. MD is not contagious and cannot be brought on by injury or activity.

There are nine major groups of muscular dystrophies. The disorders are classified by the extent and distribution of muscle weakness as well as the following:

• Age of onset
• Rate of progression
• Severity of symptoms
• Family history (including any pattern of inheritance)

Although some forms of MD become apparent in infancy or childhood, others may not appear until middle age or later. Overall, incidence rates and severity vary, but each of the dystrophies causes progressive skeletal muscle deterioration, and some types affect cardiac muscle.