Neuromuscular Disorders

ALS, Muscular Dystrophy, and More

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Duke offers advanced care for neuromuscular disorders such as amyotrophic lateral sclerosis (ALS) and muscular dystrophy that cause muscle weakness and other symptoms. As a regional and national referral center, Duke neurologists and other specialists work together to treat problems with the nerves, muscles, and the connection between the two (doctors call this the neuromuscular junction). Whether your symptoms just began, or you’ve already received a diagnosis and are seeking more advanced care, our goals are to provide education, reduce your symptoms, promote remission, and improve your quality of life.

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Neuromuscular Disorders We Treat

Neuromuscular disorders can be inherited, related to inflammation or autoimmune disorders, or caused by toxins, infections, or endocrine conditions like diabetes. Although many of these conditions are rare, Duke experts treat them often, including:

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Testing - What to Expect

During your first visit, we will take time to understand your medical history, including any previous evaluations and therapies. We will also discuss your symptoms and complete a physical exam and neurologic exam to evaluate your cranial nerves, motor strength, senses, reflexes, coordination, and walking. 

Electrodiagnostic Studies and Our EMG Lab
You will undergo electrodiagnostic testing that includes electromyography (EMG) and nerve conduction studies (NCS) on the same day as your consultation, whenever possible. These tests measure nerve and muscle activity through electrical stimulation during NCS and with a needle electrode during EMG. 

You may also benefit from single-fiber EMG, a test for myasthenia gravis. This test is not available at all other centers since providers must complete additional training to administer single-fiber EMG.

These tests are given in Duke’s specialized EMG lab, which is accredited by the American Association of Neuromuscular and Electrodiagnostic Medicine. This accreditation recognizes our high-quality care and commitment to patient safety.

Your doctor may recommend an ultrasound -- high-frequency sound waves that produce images of structures inside your body.

Tissue Biopsy
Some people may benefit from a biopsy. Using a needle, a small sample of skin or muscle tissue is removed and sent to pathologists, who examine the sample under a microscope and use staining techniques to identify abnormalities.

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Your doctors can prescribe treatments to boost function and slow symptom progression. 

  • It’s important to address any contributing conditions, like diabetes or alcohol abuse. 
  • Physical and occupational therapy helps strengthen muscles and improve range of motion.
  • Bracing helps support weak muscles, and assistive devices make it easier to complete daily tasks.
  • Medications like steroids, intravenous immunoglobulin (IVIg), plasma exchange therapy, and immunosuppressants can reduce symptoms and lead to remission.
  • Certain neuropathic pain medications can reduce symptoms of neuropathy like numbness, tingling, and pain. 
  • Injection procedures or surgery may be recommended for some people.
Clinical Trials at Duke

Our doctors are leaders in neuromuscular research, which means you may have access to new treatments like gene therapy before they’re widely available. Not only will you benefit from best practices and advanced therapies, but you can also help the next generation work toward a cure.

Why Choose Duke

We Advocate for You and Prioritize Convenience
A nurse dedicated to supporting you communicates with insurance companies to secure medication approvals, arranges for hospital admission, and more. We also have specific schedulers for EMG and nerve conduction testing because we try to arrange these on the same day as your consultation visit.

Advanced Training
Our fellowship-trained and board-certified neurologists have completed specialized training to perform EMG and nerve conduction studies. They interpret the results to help diagnose and manage neuromuscular disorders. 

Expert Collaboration
Our co-clinics for myositis, ALS, amyloidosis, and muscle dystrophy bring together a range of specialists from neurology, pulmonology, rheumatology, cardiology, and more to consolidate your care. This approach is more thorough and saves you time. We can connect you with providers who offer physical, occupational, swallow, speech, and respiratory therapies to treat all the ways a neuromuscular disorder might affect you.

Virtual Video Visits Available
Virtual follow-up visits are an option for patients who live in North Carolina.

Best Hospital for Neurology, Neurosurgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our neurology and neurosurgery program is nationally ranked, and the highest-ranked program in North Carolina by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 07/19/2022 by