Center for Neurology and Sleep Medicine
02 2291 5000

About Muscle & Nerve Clinic

Diagnosis and treatment of muscle and nerve diseases requires highly specialized tools and skills. Neuro Med provides this unique mix to patients through expert neurology consultants (Dr. Rasha El Sherif, Dr. Hossam Afify and Dr. Ahmed Elsadek) and services that are unmatched in the country.

Services

  • Advanced Nerve Conduction Studies and Electromyography (EMG)
  • Nerve Biopsy
  • Advanced Nerve Conduction Studies and Electromyography (EMG)
  • Muscle Biopsy
  • dystrophy
  • Diabetic Neuropathy
  • Inflammatory neuropathies
  • Myopathies
  • Myasthenia Gravis

Muscle & Nerve Tests

We offer a wide range of advanced genetic testing for genetic muscle diseases in collaboration with major muscle research labs around the world.

Tests include Duchenne and Becker muscle dystrophies, sacroglycanopathies and limb girdle muscle dystrophies.

First targeted treatment success for Duchenne muscular dystrophy

 

Scientists at the UCL Institute of Child Health (ICH) have led on an important breakthrough in the development of a treatment for Duchenne muscular dystrophy, as detailed in The Lancet today.

Together with the MDEX Consortium where the ICH’s Prof Francesco Muntoni is the Chair, the group have shown that an antisense oligonucleotide genetic therapy was effective in restoring the missing protein dystrophin in 7/19 trial participants, with 3 in the higher dose cohort showing for the first time levels in dystrophin exceeding 18% of those found in normal muscle. Their laboratory findings suggest that this approach could provide a functional advantage to affected patients with eligible mutations.

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  • EMG and Nerve Conduction Studies

    An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.

    Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in specific ways. Nerve and muscle problems cause the muscles to react in abnormal ways.

    If you have leg pain or numbness, you may have these tests to find out how much your nerves are being affected. These tests check how well your spinal cord, nerve roots, and nerves and muscles that control your legs are working.

    Why It Is Done

    An EMG is done to: Find diseases that damage muscle tissue, nerves, or the junctions between nerve and muscle. These problems may include a herniated disc, amyotrophic lateral sclerosis (ALS), or myasthenia gravis (MG). Find the cause of weakness, paralysis, or muscle twitching. Problems in a muscle, the nerves supplying a muscle, the spinal cord, or the area of the brain that controls a muscle can cause these symptoms. The EMG does not show brain or spinal cord diseases.

    A nerve conduction study is done to: Find damage to the peripheral nervous system, which includes all the nerves that lead away from the brain and spinal cord and the smaller nerves that branch out from those nerves. This test is often used to help find nerve problems such as carpal tunnel syndrome or Guillain-Barré syndrome.

    How To Prepare

    Tell your doctor if you: Are taking any medicines. Certain medicines that affect the nervous system can change electromyogram (EMG) results. You may need to stop taking these medicines 3 to 6 days before the test. Have had bleeding problems or take blood thinners, such as warfarin or heparin. If you take blood thinners, your doctor will tell you when to stop taking them before the test. Have a pacemaker.

    Do not smoke for 3 hours before the test.

    Do not eat or drink foods that contain caffeine (such as coffee, tea, cola, and chocolate) for 2 to 3 hours before the test.

    Wear loose-fitting clothing so your muscles and nerves can be tested. You may be given a hospital gown to wear.

    For an EMG, you may be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean.

    To help you understand the importance of this test, fill out the medical test information formpdf.

    How It Is Done

    An EMG is done in a hospital, clinic, or doctor’s office. It may be done in a room that stops any outside electrical interference. The test may be done by an EMG technologist or a doctor.

Diabetic Neuropathy

 

What are diabetic neuropathies?

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness-loss of feeling-in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

 

What causes diabetic neuropathies?

The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors:

  • metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin
  • neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves
  • autoimmune factors that cause inflammation in nerves
  • mechanical injury to nerves, such as carpal tunnel syndrome
  • inherited traits that increase susceptibility to nerve disease
  • lifestyle factors, such as smoking or alcohol use

 

What are the symptoms of diabetic neuropathies?

Symptoms depend on the type of neuropathy and which nerves are affected. Some people with nerve damage have no symptoms at all. For others, the first symptom is often numbness, tingling, or pain in the feet. Symptoms are often minor at first, and because most nerve damage occurs over several years, mild cases may go unnoticed for a long time. Symptoms can involve the sensory, motor, and autonomic-or involuntary-nervous systems. In some people, mainly those with focal neuropathy, the onset of pain may be sudden and severe.

Symptoms of nerve damage may include

  • numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
  • wasting of the muscles of the feet or hands
  • indigestion, nausea, or vomiting
  • diarrhea or constipation
  • dizziness or faintness due to a drop in blood pressure after standing or sitting up
  • problems with urination
  • erectile dysfunction in men or vaginal dryness in women
  • weakness

Symptoms that are not due to neuropathy, but often accompany it, include weight loss and depression.

 

What are the types of diabetic neuropathy?

Diabetic neuropathy can be classified as peripheral, autonomic, proximal, or focal. Each affects different parts of the body in various ways.

  • Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, hands, and arms.
  • Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.
  • Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.
  • Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.