NEUROMUSCULAR DISEASE | Neurology
EDUCATION
The resident's exposure to neuromuscular disease and diseases of the peripheral nervous system will be, in part, through the local Muscular Dystrophy Association Clinic. This clinic currently meets weekly. Eight to twelve established and new patients are evaluated each week. Enrollment of patients includes not only those with muscular dystrophy but also patients with a variety of other conditions including other hereditary muscle diseases (congenital and mitochondrial myopathies), acquired neuromuscular problems (i.e. inflammatory myopathies), diseases of the neuromuscular junction, diseases of the motor neuron (ALS, spinal muscular atrophy), hereditary neuropathies and a number of other hereditary conditions (spinocerebellar ataxias).
The resident will learn skills in performing the neuromuscular examination, in diagnosing and managing neuromuscular conditions, in genetic counseling of hereditary disorders and in utilizing allied health specialties (physical, occupational, speech/language therapy). The resident will also receive instruction in the neuropathology of neuromuscular disease including indications for and interpretation of muscle and nerve biopsy.
The in-patient service and consultation service will also provide further experience in diagnosis and management of more acute neuromuscular diseases such as myasthenia/myasthenic crisis, Guillain-Barre syndrome, traumatic nerve and plexus injury, acute weakness in the critical care unit. The outpatient clinic service will provide exposure to a similar variety of subacute and chronic neuromuscular and peripheral nerve conditions.
Neurological Medical Ethics
Over the course of his/her training, the resident can expect to receive further instruction in neurological aspects of medical ethics. A case-based curriculum will likely be the format for this instruction. A few topics that will be considered include truth-telling, ethics of genetic testing and problems regarding persistent vegetative state, brain death and transplantation. There will be opportunities to participate in and interact with the hospital ethics committee, if desired.
