Neuromuscular Clinic
The Neuromuscular Clinic (NM) Rotation (5 mos.) experience is 100% outpatient with weekly half day EMG/NCV, Muscle/Nerve biopsy reading, Pediatric Neuromuscular clinic UTSHC, and Muscular Dystrophy Association (MDA) fellow’s clinic. The outpatient experience occurs at the Stanley H. Appel Department of Neurology, Scurlock Towers, Ste. 802, a 36-examination room clinic with a separate nurse and physician workspaces, the internet, and computer services and resources, and clerical and medical support. Fellow will rotate with Dr. Sheetal Shroff in EMG/NCS Monday afternoon, Tuesday all day clinic which includes both new and follow-up patients with a variety of neuromuscular disorders and Wednesday afternoon for biopsies & ultrasounds.   

ALS/Neuromuscular Rotation
The ALS/Neuromuscular (NM) Rotation (2 mos.) experience is also 70% outpatient and 30% inpatient (admits, consults) with weekly half-day clinics in EMG/NCV, Muscle/Nerve biopsy reading, Pediatric Neuromuscular clinic, and Muscular Dystrophy Association (MDA) fellow’s clinic.

The outpatient experience occurs on the outpatient workup unit located on the 11th floor of the West Pavilion of the Houston Methodist Hospital. The unit has 24 beds, six chair infusion suite, a 4 bed EMG/NCV unit. Patients are referred for a 2-3-day outpatient evaluation, treatment plan or treatment predominantly under the supervision of Dr. Stanley H. Appel. The patient population evaluated on the unit is made largely of ALS patients and other neuromuscular disorders including CIDP, myasthenia gravis, autoimmune neuromuscular disorders and muscular dystrophies.

The inpatient experience also includes the evaluation and treatment of the admitted neuromuscular patient under the supervision of a neuromuscular attending. The inpatient service is made up of a variety of cases including AIDP, Myasthenia gravis exacerbation/crisis, critical illness neuropathy and myopathy, rhabdomyolysis, acute respiratory failure associated with other neuromuscular disorders (dystrophy, ALS, inflammatory myopathies).

EMG/NCV Rotation
The EMG/NCV Rotation is a three-month outpatient experience (including inpatient consults for EMG/NCV). It is located on the outpatient workup unit located on the 11th floor of the West Pavilion of the Houston Methodist Hospital. Fellows will be taught the basics of electrodiagnostic testing including safety, NCV, EMG, and RNS and its application in the diagnosis of motor neuron disorders, disorders of neuromuscular junction, myopathies, myotonic syndromes and disorders of muscle hyperexcitability, peripheral neuropathies, radiculopathies, and plexopathies under the guidance and supervision of Drs. Rosenfield, Smith, Shroff, Liao & Anderson.  

Elective
Fellows are provided two months for elective rotations which include PMR, Research, Muscle and Nerve Histopathology, or EMG/NCS or neuromuscular pulmonology. The electives allow the resident to gain additional exposure and training to these subspecialties based on their interests and future career/academic goals. These rotation experiences are all located at the Houston Methodist Hospital under the guidance of the respective program faculty.

Neuromuscular Clinic
A multidisciplinary approach to assist patients with neuromuscular diseases to live with their condition and apply the latest therapies and proactive symptom management in a positive and caring setting.

Multidisciplinary Clinics

MDA/ALSA ALS Clinic 
First and largest multidisciplinary care center for patients with amyotrophic lateral sclerosis (ALS) in the United States dedicated to the treatment of ALS, also known as Lou Gehrig's disease. Many of our team members have practiced together for over 20 years and we hold ourselves to the highest standards when caring for patients with ALS.

• Clinic occurs every 1st Friday of the month
• Fellow’s role is primarily for acquiring research data and observing continuity of care

Myotonic Dystrophy Clinic
The clinic addresses and minimizes the challenging aspects of this multisystemic disorder, help improve survival and quality of life, and foster research. The clinic is staffed by a team that includes neurologists, a cardiologist, respiratory therapist, sleep specialist, nutritionist, social worker, genetic counselor, physical and occupational therapists, and home health agency vendors. It offers a range of laboratory and diagnostic testing to assess patients for related diseases.

• Clinic is held four times a year
• Fellow is assigned patients that are staffed by attending
  
  

Diagnostic Laboratories

Neuromuscular & Electrodiagnostic Medicine

• Electromyography & Motor Control Laboratory
• Neuromuscular ultrasound
• Muscle & Nerve Histopathology Laboratory