Diagnosis and Treatment

The program that other doctors count on

Primary care physicians and other doctors often look to the Neuromuscular Disorders Program to make or confirm diagnoses. At Tufts Medical Center, we strive to incorporate the latest advances in the diagnosis of neuromuscular disorders. Our neurologists begin this process by reviewing your medical history and discussing your health with you at length. In finalizing a diagnosis, they can employ a variety of techniques, such as:

  • Electromyography (EMG) and nerve conduction studies (NCS) involve stimulating nerves with a small electrical current (NCS) and inserting a thin needle into the muscle (EMG) to measure electrical activity and uncover any neuromuscular abnormalities. These 2 components are almost always performed as part of the test. Details and preparations for this procedure are explained here.
  • Punch skin biopsy involves taking a small piece of skin to look at the nerve fibers. This is an essential test for the diagnosis of polyneuropathy affecting small nerve fibers, which is often missed with other diagnostic procedures. Details and preparations for this procedure are explained here.
  • Forearm exercise test is a simple blood extraction in the forearm before and after performance of a short exercise. This is a very useful test in the diagnosis of certain disorders affecting the metabolic functions of the muscles. Details on this procedure are explained here.
  • Quantitative sensory testing (QST) may be requested by your physician to monitor your ability to detect either vibration and temperature, or both. This is an important test in the diagnosis and monitoring of polyneuropathies.
  • Blood tests involve taking a blood sample from a vein in your arm to help distinguish the type of neuromuscular disorder.
  • Lumbar puncture (spinal tap) involves a needle being inserted between two lumbar bones (bones that form the spine) to remove a sample of fluid to help determine the type of neuromuscular disorder.
  • Imaging (e.g. magnetic resonance imaging, or MRI) is a scan of the brain and spinal cord to help determine the type of neuromuscular disorder.
  • Nerve and/or muscle biopsies involve a small piece of tissue being removed from a specific muscle to help determine the neuromuscular disorder. Sometimes, taking a small piece of skin may be needed.

We strive to offer the latest medications for all neuromuscular disorders. Our neurologists present your options and then work with you to determine the best course of action. The precise nature of your therapy depends on factors such as the disease, its stage of progression and your symptoms. Along the way, we make a special effort to educate family members about your condition so they can help care for you if necessary.

Of course, many neuromuscular diseases lead to, or are related to, other health problems. So we work closely with other Tufts MC specialties, such as, internal medicine, physical medicine and rehabilitation, orthopedic surgery, neurosurgery, rheumatology, ophthalmology, urology, psychiatry to manage your overall well-being.

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Dr. Oscar Soto talks about ALS

Q&A with Dr. Soto

We spoke with the director of our Neuromuscular Division about ALS, also known as Lou Gehrig's Disease.

Learn more about ALS