Neuromuscular diseases are a large group of disorders with various causes sharing one common characteristic--muscle weakness. One large group of neuromuscular diseases is caused by abnormalities in the nerves as they exit the brainstem and spinal cord and travel out to their respective muscles. These are called "neuropathies." Common examples in this group include spinal muscular atrophy (SMA) and Charcot-Marie-Tooth disease. Another large group of neuromuscular diseases, the "myopathies," are caused by abnormalities in the muscle tissue. Some of the more common examples include Duchenne muscular dystrophy and myotonic dystrophy. A less common cause of neuromuscular weakness are the disorders of neuromuscular transmission. These are caused by abnormalities at the spot where the nerves attach to the muscle. Examples of disorders of neuromuscular transmission include myasthenia gravis and botulism.

The needs of children with neuromuscular diseases are variable and frequently require coordinated, multidisciplinary care involving a number of different specialists. The program's faculty and staff include multiple pediatric specialists, including a neurologist, cardiologist and pulmonologist in addition to a nurse clinician/coordinator and physical therapist. Due to the complex nature of our patients' conditions, we also work closely with representatives from adult neurology, child development and behavioral health, gastroenterology and nutrition, medical genetics, neuropsychology, neurosurgery, occupational therapy, orthopedics, respiratory therapy, social work, and speech pathology. 

From left to right: Heather Henderson, MD; Stephanie Wechsler, MD; Laura Case, PT; Missy Pittman, RN; Jennifer Olson, RN; Edward Smith, MD; and Richard Kravitz, MD. 

Mission
The mission of the Duke Comprehensive Neuromuscular Clinic, under the co-direction of Edward C. Smith, MD and Richard Kravitz, MD, is to offer exceptional care to infants, children, adolescents and young adults with neuromuscular disorders by providing comprehensive specialty care to improve the quality of their lives through compassionate and innovative services for our patients and their families.

Goals
The primary goals of the clinic are to provide:

1. State-of-the-art diagnostic evaluations and therapy for patients with pediatric neuromuscular disorders in a timely manner. This may include specialized laboratory studies, electromyography and muscle biopsy.
2. Clinical counseling, anticipatory guidance, and up-to-date, accurate information relevant to the patient’s diagnosis.
3. Information regarding pertinent clinical trials and assistance with enrollment.
4. Timely referral to appropriate specialists and therapists.

Treatments

The Duke Children's Comprehensive Neuromuscular Program offers coordinated, multidisciplinary care for infants, children, adolescents, and young adults with a wide variety of neuromuscular disorders, including:

• Duchenne Becker and other forms of congenital muscular dystrophies
• Limb-girdle muscular dystrophy, myotonic dystrophy, and metabolic myopathy
• Neuromuscular junction disorders including myasthenia gravis and congenital myasthenic syndrome
• Peripheral neuropathies, including Charçot-Marie-Tooth disease and other hereditary neuropathies, as well as acquired neuropathies such as acute and chronic inflammatory demyelinating neuropathies, etc.
• Spinal Muscular Atrophy (SMA)
• Brachial Plexus injuries

The diagnosis and treatment of children with neuromuscular diseases can be difficult and requires timely evaluations, expert diagnosis and testing. Our team is committed to providing the most current, comprehensive and specialized care possible.

Physicians and Staff

Physicians

Staff

Clinic Hours and Locations

Appointments and Contact Information

To serve our patients and referring physicians, faculty physicians covering pediatric pulmonary are always on call to answer questions and provide consultation.

• For new and return appointments, prescription refills, or to speak with a nurse, please call Jennifer Pendleton Olson, RN, BSN at 919-613-6832.
• For urgent calls after business hours, on weekends, or on holidays, please call 919-684-8111 and ask the operator to page the pediatric pulmonologist on call.
• For physicians requesting consultations or making referrals, please call the Duke Consultation and Referral Center at 800-MED-DUKE (800-633-3853).