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NEUROMUSCULAR DISORDERS

The Neuromuscular Disorders Division of the Department of Neurology is vibrant and growing with 8 faculty focusing on different aspects of diseases of nerve and muscle. Five of the faculty practice at Vanderbilt University Medical Center whereas one serves at the Veterans Administration Hospital and two at the Children’s Hospital.

The Muscular Dystrophy Association (MDA) has designated the Vanderbilt Neuromuscular Clinic as an MDA/ALS Clinic. Comprehensive diagnostic, treatment, and follow up care are provided for people with neuromuscular disorders covered by the MDA. Among the many disorders covered are the muscular dystrophies, motor-neuron diseases like ALS (Lou Gehrig's disease), spinal muscular atrophies, genetic neuropathies (Charcot-Marie-Tooth disease), glycogen storage diseases, and periodic paralysis. The MDA website (www.mdausa.org) lists the disorders the organization covers.

Vanderbilt's MDA Neuromuscular Clinic is the only one in the Mid-South with a complete range of services that include specially trained physicians, physical therapists, occupational therapists, speech pathologists, nutritionists, and other experts who provide and maintain mobility equipment such as wheelchairs and splints. Patients in the MDA Clinic have the opportunity to enroll in national research studies and drug trials as they become available. Since 1970, the MDA has provided financial support to the clinic making it possible to provide physician services and mobility equipment that insurance will not cover.

Faculty and Staff
Dr. Peter Donofrio is the Director of the Division of Neuromuscular Disorders and is the Director of the MDA Clinic and the MDA/ALS Clinic. He has a special interest in ALS, myasthenia gravis, and peripheral neuropathy. Dr. Donofrio is currently conducting clinical trials in ALS and in myasthenia gravis. He has interests in drug research to slow the progression of respiratory failure in ALS and in exercise therapy for the same condition.

Dr. Bryan Burnette is a pediatric neurologist and a pediatric neuromuscular specialist. He primarily sees children with muscular dystrophies, spinal muscular atrophy, peripheral neuropathies, and childhood and juvenile myasthenia gravis.

Dr. Jane Howard, the Associate Director of the MDA Clinic, has been active in the section since 1993. She focuses on muscular dystrophies, inherited neuropathies, myasthenia gravis and ALS.

Dr. Anthony Kilroy is a pediatric neurologist. He primarily practices electrodiagnosis (nerve conduction studies and EMG) in children and adults in the Neuromuscular Division.

Dr. Christopher Lee specializes in myasthenia gravis, amyotrophic lateral sclerosis, and peripheral neuropathy. His research currently includes projects evaluating muscle ultrasound in amyotrophic lateral sclerosis and evaluating early clinical and electrodiagnostic features of critical illness polyneuropathy and myopathy.

Dr. Jun Li has a clinical interest in inherited neuropathies (also called Charcot-Marie-Tooth diseases or CMT), which is also the focus of his laboratory research. He has published extensively and received recognition internationally in the field of CMT. His clinic focuses on patients with CMT and other inherited neuropathies.

Dr. Amanda Peltier specializes in diabetic neuropathy, autonomic disorders, chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, myasthenic syndrome and ALS. Her research focuses on the interaction between the metabolic syndrome and the autonomic and peripheral nervous system. Dr. Peltier also sees patients in the Eskind Diabetes Clinic as part of a multidisciplinary clinic to serve patients with diabetes mellitus.

Judy Corfman, RN, NP, is the Nurse Practitioner (NP) for both the MDA Clinic and the ALS Clinic. She is also the Clinic Coordinator for the ALS Clinic.

Angela Mayer is the MDA coordinator for both the weekly MDA Clinic and the monthly ALS Clinic.

Physician Information
Patient appointments in the MDA Clinic require the referring physician to send records to Vanderbilt University Medical Center for review and assignment.

Patient Information
The MDA clinic meets every Thursday afternoon and evaluates patients of all ages with neuromuscular disorders covered by the MDA Clinic. The clinic is located in the basement of the Preston Research Building on the campus of Vanderbilt University Medical Center. The MDA coordinator, a physical therapist, and a durable medical equipment vendor are present at each MDA clinic to assist clients.

The ALS clinic is held the first Friday of every month on the third floor of The Vanderbilt Clinic. The MDA ALS Clinic is staffed by physicians, physical therapists, occupational therapists, speech therapists, dieticians, assistive technology, social workers, pastoral care and counseling, a durable medical equipment vendor, and MDA personnel. If the patient uses braces and/or wheelchair, these items should be brought to the clinic. The function and fit of the equipment will be evaluated. To contact the clinic directly, call (615) 322-7246.

For more information on the Neurodiagnostics Lab, click here.

Research
The Division has a long history of participating in clinical studies of promising treatments. Past studies have tested drug therapy in Duchenne muscular dystrophy and ALS. The clinic has recently joined a national consortium of neuromuscular centers to participate in therapeutic trials on ALS and pediatric neuromuscular disorders.

With the addition of new faculty, new efforts have been directed to investigate the mechanisms and therapeutic potentials of various neuromuscular diseases. Dr. Li’s laboratory has focused on the inherited neuropathies (CMT). CMT is investigated at different levels of the biological systems, including culture neurons/Schwann cells, genetically manipulated animal models and human subjects with CMT. (Please visit http://www.mc.vanderbilt.edu/neurology/faculty/li.htm for details). Current efforts are also to collaborate with other basic science programs at Vanderbilt, including genetics research with Dr. Alfred George (http://dna.mc.vanderbilt.edu/genetics/default.htm), advanced MR imaging with Dr. Bruce Damon, and Schwann cell biology research with Dr. Bruce Carter (https://medschool.mc.vanderbilt.edu/carterlab/). Dr. Peltier has an ongoing collaboration with the Vanderbilt Autonomic Disorders Center investigating peripheral autonomic function in disorders such as postural tachycardia syndrome, autoimmune autonomic neuropathy, and pure autonomic failure. (http://www.mc.vanderbilt.edu/root/vumc.php?site=adc).

Education
Vanderbilt's Neuromuscular Division has a long and prestigious reputation for training medical students, neurology residents, and neurology fellows in the clinical and laboratory aspects of diseases affecting the nerve, muscle, spinal cord, and neuromuscular junction. Patients evaluated in the neuromuscular section may have examinations and testing in which clinical fellows, residents, and medical students participate, in addition to the comprehensive evaluation by one of the faculty physicians.