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Neuromuscular Outpatient Clinic

The neuromuscular outpatient clinic works on recognizing dieases of the nerves/muscles as well as therpeutic solutions and treatment. Patients with the following symtoms are treated here:

  • Amyotrophic lateral sclerosis
  • Spinal muscular atrophy
  • Post-Polio syndrome
  • Nerve root/ nerve injury
  • Inherent or aquired polyneuropathy
  • Muscle diseases such as Myasthenia gravis, muscular dystrophy, muscle inflammation and muscle pain
  • Hereditary spastic spinal paralysis

Neurological Outpatient Clinic
Tel: 06131 17-3110


Dr. Sonja Gröschel                                                Dr. Cora Rebhorn
Specialist in neurology                                         Specialist in neurology      

Univ.-Prof. Dr. Frank Birklein
Section Head

Neuromuscular Diseases

Skeletal muscles are innervated by a group of neurones (lower motor neurones) located in the ventral horns of the spinal cord which project out the ventral roots to the muscle cells. These nerve cells are themselves innervated by the corticospinal tract or upper motor neurones that project from the motor cortex of the brain.  When there is a disturbance in the junction where the muscles and nerves meet, neuromuscular diseases begin. This term covers a wide variety of disorders.

Classification, causes
In this classification system, diseases that either hereditary due to a genetic trait or occur spontaneously. This is true of spinal muscular atrophy, Hereditary Spastic Paraplegia, hereditary neuropathies, and many muscle disorders such as muscular dystrophy or myotonia. Poliomyelitis, polyneuropathy, polyneuritis or muscle inflammation (myositis) are triggered by inflammation. Amyotrophic lateral sclerosis (ALS) is a degenerative disease whose causes are still unknown.
As a result of metabolic disorders such as diabetes, alcohol, toxins (botulism, tetanus) or drugs, neuropathies and muscle diseases (myopathies) may occur.
Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. For example, Guillain-Barre syndrome is a disease which can become chronic. Various other forms of neuropathy are also caused by inflammation. When there are problems at the structure of the junction between nerve and muscle disorders, myasthenia gravis or Lambert-Eaton syndrome may occur.
Diseases such as fibromyalgia, chronic fatigue syndrome, CK elevations and several neuropathies have no clear origin.

The diagnostic includes a comprehensive survey of the patient's medical history and clinical examination, especially of muscle strength and mass. These findings can often be assigned to a specific group of diseases (muscular disease, neuromuscular transmission disorder, neuropathy, Motoneuron disease). For a detailed classification of the disease, further diagnostic steps are necessary as is laboratory parameters such as electrophysiological, MRI and molecular genetic studies. The study of the lung and heart function by checking the breathing capacity and ultrasound of the heart muscle may be ncessary in certain cases.

The causes of neuromuscular disease are so various that the events triggering the disease must always be noted. Only then can the therapy be derived. Each disease requires an individual investigation, treatment and counseling.