Neuromuscular disorders

Through collaborative efforts with local ALS clinics, the team provides integrated co-managed ALS care for Veterans already being seen in the private sector, as well as, care for Veterans seen only in the VA system.

Services offered at our ALS clinic include all primary health and specialty care services, plus:

• ALS patient and caregiver support groups
• Assistive technology and wheel chair clinics
• Care coordination and homecare
• Physical  and occupational therapy
• Speech Pathology

The Minneapolis VA Health Care System has been named a Certified Treatment Center of Excellence by the ALS Association.

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An NCS assesses nerve damage and dysfunction. An EMG tests the function and health of the muscles.

Preparing for your appointment

Get ready for your NCS or EMG

• Your skin should be clean; please do not put any lotion on your skin after showering.
• Wear loose fit clothing.
• Wear undergarments.
• Take all your regular medications.

You do not need to fast for the test.

Information you should tell your provider before an NCS or EMG

• If you are taking blood thinners.
• If you have a pacemaker.
• If you have an internal defibrillator.
• If you have a DBS or VNS implant.

How the test is performed

The test usually includes two parts:

1. Nerve conduction studies (NCS) and
2. Electromyography (EMG)

Nerve conduction studies are done by placing sticker electrodes on the skin and applying electrical stimulation to the nerves. Measurements are made of how fast and how well a nerve carries a message.

The electromyography is done by placing a thin needle into the muscle. No electrical stimulation is applied during the muscle testing as the needle picks up the electrical activity normally present in the muscle. This electrical activity is shown on a screen and can be heard over a speaker.

EMG’s can be painful, but most people are able to tolerate it well. You can request that the physician stops the test at any time.

The physician will discuss the results with you before you leave. The results are then sent to the provider who ordered the test.

What to do after testing

You won’t need a driver for this test. You may return to your normal activities right away. You may feel some soreness where the needle was put in for a short time after the test. Using ice packs can help this.

An MRI uses a strong magnetic field and radio waves to create detailed images of the organs and tissues within the body.

A lumbar puncture (LP) is the insertion of a small needle into the lower back to collect and examine the fluid that surrounds the brain and spinal cord.

All three biopsy types can be used to help identify or confirm specific diagnoses.

Muscle biopsy

A muscle biopsy is the removal of a small piece of muscle tissue for testing.

Skin biopsy

A skin biopsy is the removal of cells or skin samples from your body for testing.

Nerve biopsy

A nerve biopsy is removal of a small piece of nerve for examination.

ALS is a rare disease that primarily affects the nerve cells responsible for controlling voluntary muscle movement. There is no cure for this disease, and it gets worse over time. Eventually it causes people to lose their strength, ability to move their body, and the ability to breathe on their own.

Learn more about ALS

Carpal tunnel syndrome is when the median nerve is compressed as it travels through the wrist. Symptoms of carpal tunnel syndrome are tingling, numbness and shock like sensations in the fingers or hand, except for the pinky.

Charcot-Marie-Tooth disease is an inherited disease that affects the nerves in the feet, legs, hands and arms. Symptoms may include weakness, muscle loss, footdrop, high arches and curled toes.

CIDP is a rare disease that is caused by damage to the covering of the nerves. This causes messages transmitted from the brain to be disrupted. Numbness, tingling and pain, loss of reflexes, weakness, difficulty walking and foot drop can be symptoms of CIDP.

Guillain-barre syndrome (GBS) is when a person's own immune system attacks their nerves. The symptoms usually start with weakness or tingling sensations in the legs and can spread to the arms and face.

Muscular dystrophy (MD) is an inherited condition that causes the muscles to weaken and gets worse over time. There are various types of MD and depending on the type, different muscles and parts of the body are involved.

 

Myasthenia gravis (MG) is an autoimmune disease that affects the communication between nerves and muscles. It causes muscle weakness that worsens after periods of activity and improves after periods of rest.

Myopathy refers to disorders that affect the muscles that connect to your bones (skeletal muscles). A common symptom of myopathy is muscle weakness on both sides of the body, especially in muscles closest to the center of the body (upper arms, upper legs).

Peripheral neuropathy is where the nerves that send signals between the brain and spinal cord and the rest of the body are damaged. Symptoms are sensations of tingling, numbness, pain, burning, touch sensitivity, poor coordination, muscle weakness, paralysis, and feeling like gloves are on the hands or socks are on the feet.

Peroneal neuropathy occurs when the peroneal nerve in the leg is injured. This can lead to loss of movement or sensation in the foot and leg.

Ulnar neuropathy occurs when the ulnar nerve is compressed as it travels across the elbow or the wrist. It can cause numbness, tingling and pain in the arm and certain fingers. This is often referred to as tennis elbow.