The Division of Neuromuscular Disease provides inpatient care at UPMC Presbyterian in the Oakland section of Pittsburgh, Pennsylvania. Outpatients are seen in the Kaufmann Medical Building. Are clinics include
Muscular Dystrophy Clinic
To treat outpatients with amyotrophic lateral sclerosis, the division coordinates the MDA/ALS Multidisciplinary Clinic, a clinic designed for people who require treatment from many specialists, for example, physical therapists, occupational therapists, speech pathologist, social workers, and dietitians. The clinic offers the opportunity to receive many types of care in the same place and, in some cases, during the same visit. The clinic allows the specialists in a patient’s care to confer and coordinate treatment, leading to decisions based upon sound information and feedback. The Muscular Dystrophy Association support staff is available at the clinic to answer questions.
The MDA/ALS Multidisciplinary Clinic is held on the fourth Friday of each month in the Kaufmann Medical Building, Suite 810, and is staffed by two neurologists, Drs. David Lacomis and Sasa Zivkovic. To schedule an appointment in the MDA/ALS Multidisciplinary Clinic, call Rebecca Molczan, RN, CRNP, at (412) 692-4917.
Patients may also be eligible for clinical research trials and other investigations. Further information regarding clinical research trials may be obtained at the Center for ALS Research website.
Muscular Dystrophy Clinic
Patients seen by Drs. Paula Clemens, David Lacomis, Chitharanjan Rao, and Sasa Zivkovic are also eligible for supportive services provided by the Muscular Dystrophy Association through the Muscular Dystrophy Clinic. Patients who may receive supportive services from the MDA will have disorders which include:
- All types of muscular dystrophies
- Metabolic muscle diseases
- Inherited disorders such as glycogen and lipid storage, mitochondrial, etc.
- Disorders arising from thyroid problems
- Congenital myopathies
- Inflammatory myopathies
- Myasthenia Gravis
- Spinal muscular atrophy
- Amyotrophic lateral sclerosis, and
- Charcot-Marie Tooth Disease.
The Muscular Dystrophy Clinic is held on Monday mornings in the Kaufmann Medical Building, Suite 810, and is staffed by Drs. David Lacomis, Paula Clemens, and Sasa Zivkovic. Dr. Chitharajan Rao also specializes in Charcot-Marie-Tooth Disease as well as peripheral neuropathies. To schedule an appointment in the Muscular Dystrophy Clinic, call Rebecca Molczan, RN, CRNP, at (412) 692-4917.
Botulinum toxin (either Botox® or Myobloc®) is used for treatment of patients with dystonia and spasticity. Dystonia is a movement disorder characterized by sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions. The neck is most often affected, producing cervical dystonia or torticollis. Two-thirds of patients diagnosed with torticollis improve with botulinum toxin therapy. Focal limb dystonias, such as writer’s cramp, also respond well to such treatment. Blepharospasm and hemifacial spasm are movement disorders of facial muscles that are also treated by botulinum toxin. Muscle stiffness (spasticity) from stroke or multiple sclerosis may also be relieved with botulinum toxin treatment.
Botulinum toxin is a protein produced by the bacteria Clostridium botulinum. When ingested orally, the toxin can cause food poisoning, known as botulism. When injected into the muscles, botulinum toxin blocks the chemical impulses from the nerve to the muscle, causing a temporary local weakness called chemodenervation. This leads to weakening of muscle contractions and relief of dystonia. The success of injections rests largely with muscle selection, dosage, and preparation of the botulinum toxin serotypes. Dr. David Lacomis utilizes EMG-guided injections to assure the accuracy of the injection into the appropriate muscle. The benefit usually begins within days of the injection, peaks at approximately four weeks, and lasts three to four months.
Botox and additional treatments for patients with dystonia and movement disorders are also offered through the Movement Disorders Clinic.
Dr. David Lacomis holds Botox Clinic every Thursday AM in the Kaufmann Medical Building, Suite 810. To schedule an appointment with Dr. Lacomis in the Botox Clinic, call (412) 647-4920.