Multi-disciplinary Neuromuscular Clinic

Overview

Overview of Services

Neuromuscular diseases are a complex group of disorders primarily involving the peripheral nervous system.

These can include disorders of the motor neurons such as amyotrophic lateral sclerosis, peripheral nerves such as Charcot Marie Tooth disease, neuromuscular junction disorders such as myasthenia gravis and disorders of muscle such as Duchenne muscular dystrophy. Common symptoms can include weakness, numbness or difficulties with walking. 

Dean's Multi-disciplinary Neuromuscular Clinic offers treatment for neuromuscular disorders by a team of health care specialists from different disciplines. We strive to be able to provide this care at the Dean & St. Mary’s Outpatient Clinic in one visit.

This approach allows for improved comprehensive care, convenience for our patients, as well as ease for discussion of patient care amongst treatment team members. The Neuromuscular Clinic is also partnered with the Muscular Dystrophy Association (MDA) to provide care for patients with disorders covered by the MDA.

Covered Disorders

Covered Muscular Dystrophy Association disorders include:

• Muscular Dystrophy
  • Duchenne muscular dystrophy, Becker muscular dystrophy, congenital muscular dystrophy, limb-girdle, myotonic dystrophy, facioscapulohumeral muscular dystrophy (FSH), Emery-Dreifuss, etc.

• Motor Neuron Disease (learn the details about this disease and the drugs used to treat it - PDF files) 
  • Amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA), Kennedy’s disease, etc.

• Congenital Myopathy
  • Centronuclear myopathy, myotubular myopathy, nemalin myopathy, central core disease, etc.

• Metabolic Myopathy
  • Glycogen storage myopathy – Acid maltase deficiency/Pomp disease, McArdle disease, etc.
  • Lipid storage myopathy
  • Mitochondrial myopathy

• Inflammatory Myopathy
  • Polymyositis
  • Dermatomyositis
  • Inclusion body myositis

• Hereditary Motor and Sensory Neuropathy
  • Charcot-Marie-Tooth Disease

• Myasthenia Gravis and Congenital Myasthenia Gravis
• Myotonic Dystrophy
  • Myotonic dystrophy type 1
  • Myotonic dystrophy type 2
  • Proximal myotonic dystrophy

• Friedreich's Ataxia

More information about MDA-covered disorders can be found on the Muscular Dystrophy Association website.

Additional disorders seen in the Neuromuscular Clinic include:

• Motor Sensory Peripheral Neuropathy
• Guillain-Barre Syndrome
• Chronic Inflammatory Demyelinating Polyradiculopathy
• Mononeuritis Multiplex
• Multi-focal Motor Neuropathy

A Clinic Visit

Receiving Care at Dean

During outpatient visits, patients will initially be evaluated by Drs. Oliver Ni or Michael Snyder. Our neuromuscular specialists are both board certified by the American Board of Neurology and Psychiatry in the subspecialty of neuromuscular medicine. Drs. Ni or Snyder will then coordinate the remainder of the visit with our treatment staff depending on the needs of the patient.

Patients can also potentially work with:

• Physical Therapists - In the neuromuscular clinic, physical therapists aid patients with difficulties walking from weakness or incoordination. Physical therapists also assist with selecting appropriate supportive devices such as orthotics, ankle foot orthotics, walkers or wheelchairs. Family members and caregivers are also educated about safe transfers of patients at home, home safety as well as referrals to home health.
• Occupational Therapists - In the neuromuscular clinic, our Occupational Therapist assists in finding ways to accomplish activities of daily living (eating, bathing, dressing, writing, sleeping, etc.), work and leisure by collaborating with the patient on the appropriate use of adaptive equipment, compensatory techniques, home and work modifications, and community resources. Occupational Therapists also use therapeutic exercise, energy conservation techniques and joint protection techniques to maintain functional daily activity.
• Speech Therapists - In the neuromuscular clinic, speech therapists work with patients who have difficulties swallowing. Patients who have difficulties with speech are also considered for assistive communicative devices.
• Social Worker - In the neuromuscular clinic our social worker helps patients and families understand and cope with their initial diagnosis; develop plans for supporting the patients in the home; develop safety plans for the patients and families; and provide a bridge to outside services with resources and referrals. The goal of the social worker is to communicate and demonstrate to the patients and families that they are not alone on their journey to joyful, supportive and safe living for the person diagnosed with a neuromuscular disease.
• An Adaptive Equipment (Orthotics) Specialist - Our partners from Aljan Orthotics evaluate and treat mobility issues with orthotics.
• A Genetics Counselor - Genetics counselors educate patients about genetic diseases, potential testing for genetic disorders, risks and benefits of testing, risks of passing diseases to children as well as counseling about future decision making.
• Nurses
• Nurse Assistants
• An MDA Representative

Electromyography (EMG)/nerve conduction studies and muscle/nerve biopsy services are also available if needed.

Same-day and next-day urgent appointments are available for current patients, and referral services are available if needed for pulmonology, cardiology, neuropsychology, psychology, speech therapy and other services.

Muscular Dystrophy Services Available in Partnership with the MDA

Dean’s Muscular Dystrophy Health Care Services Coordinator educates patient on resources available through the MDA organization for 43 different neuromuscular diseases. Free services for eligible participants include:

• Four clinical appointments per year under the care of Dr. Ni and Dr. Snyder.
• One physical therapy, occupational therapy, speech-language therapy and respiratory therapy appointment per year.
• An annual flu shot.
• $500 per year toward the repair and modification of wheelchairs, leg braces and communication devices.
• Other free services to those who are eligible.

Please contact Ellen at (608) 222-3269 or EKumm@mdausa.org for more information or questions regarding registration with the Muscular Dystrophy Association and how to become involved. More information can also be found on the MDA website.

Our Staff

Our Physicians

Oliver Ni, MD
	Dr. Ni is board certified in Neurology and is a diplomate of American Academy of Neurology and the American Association of Neuromuscular and Electrodiagnostic Medicine. Additionally, he is board certified in the subspecialties of neuromuscular diseases and electrodiagnostic medicine. He received his Bachelor of Arts degree from Johns Hopkins University, Medical Doctorate from the University of Florida and a Master of Science in Clinical Investigation at Washington University in Saint Louis. Dr. Ni completed his Neurology residency at the University of Utah Hospital and Clinics and fellowship in neuromuscular diseases including nerve and muscle pathology and clinical neurophysiology from Washington University in Saint Louis. Dr. Ni is the director of the Neuromuscular Clinic, EMG/NCS laboratory and nerve and muscle pathology laboratory. He is also the principal investigator at the Dean Foundation for the Northeast ALS Consortium. He has special interest in neuromuscular diseases including neuropathy, myopathy, statin myopathies, muscular dysrophies, hyper-ck-emia, disorders of the neuromuscular junction such as myasthenia gravis, motor neuron disease including ALS/Lou Gehrig’s disease, electromyography, and nerve conduction studies. View Dr. Ni's full profile.
Michael Snyder, MD
	Dr. Snyder is board certified in Neurology and is a member of the American Academy of Neurology, American Academy of Neuromuscular and Electrodiagnostic Medicine, and Alpha Omega Alpha Medical Honor Society. He received his medical degree from the University of Iowa.  Dr. Snyder completed both his Neurology residency and Neuromuscular/EMG at Washington University in St. Louis. He has special interest in general Neurology, neuromuscular diseases including neuropathies, myopathies, muscular dystrophies, motor neuron disease (Lou Gehrig’s disease), electromyography, and nerve conduction studies. View Dr. Snyder's full profile.

Our Care Team

Amy Brossard, MS-OTR

Amy assists in finding ways to accomplish activities of daily living (eating, bathing, dressing, writing, sleeping, etc.), work and leisure by collaborating with the patient on the appropriate use of adaptive equipment, compensatory techniques, therapeutic exercise, home and work modifications, and community resources. For more information about Dean Occupational Therapy, please visit our Occupational Therapy section.

Curt Campbell, MPT

Curt received his Master's degree in Physical Therapy from the University of Washington. He has received special training in neurological disorders including Multiple Sclerosis, Parkinson's Disease and Vestibular (balance) disorders. He has special interests in manual, neurologic and vestibular therapy and is currently seeking certification as an MS Certified Specialist. Curt sees MS clients on-site at the Dean Neurological Institute and Spine Center. Curt provides evaluations for manual and power wheelchairs and other assistive technology. For more information about Dean Physical Therapy, please visit our Physical Therapy section.

Michelle Dahlie, OTR/L

Michelle graduated from the University of Wisconsin-Madison in 2002 with bachelor’s degrees in Occupational Therapy and Spanish. She has worked in inpatient rehabilitation, nursing homes, alcohol and drug rehab, and outpatient settings. She has experience in both neurological and upper extremity orthopedic conditions. For more information about Dean Occupational Therapy, please visit our Occupational Therapy section.

Doreen Dybevik, RN

Doreen obtained her Bachelor of Science degree in nursing from the University of Wisconsin. She’s worked in Dean Clinic Neurology since 1998, and worked with Drs. Ni and Snyder to set up the neuromuscular clinic and muscular dystrophy clinics. Doreen works with patients daily to assess and plan for their needs, find resources and coordinate care. In addition to working closely with the Muscular Dystrophy Association, Doreen works closely with the National ALS Association and the Wisconsin Chapter of ALS. Doreen also collaborates with Home Health United and Hospice Care to assist in comprehensive care delivery for Dean’s patients.

Andre Fleuette, BS, SWTC

Andre is a Social Worker in Training in the state of Wisconsin, having received a Bachelor’s of Science Degree in Psychology with an emphasis in bio-psychology from the University of Iowa in 1987 and having completed his coursework for his Master’s of Social Work. He has practiced in Orange County, California for thirteen years as a Senior Social Worker in Children and Family Services, including three years in Special Medical Investigations and ten years as an in-home Conditional Release Program Senior Social Worker. He has served as a clinical staff member in the Dean Memory Assessment Clinic for the last three years providing psycho/social assessments, crisis intervention, and resource and referral information to families of patients dealing with dementias.

Ellen Kumm, Health Care Services Coordinator

Ellen Kumm is the MDA Health Care Service Coordinator for 19 southwestern Wisconsin counties. She graduated from the University of Wisconsin-La Crosse with a Bachelor's of Science in Community Health Education. She provides patients with free services, resources and education for 43 different neuromuscular diseases. Please contact Ellen at (608) 222-3269 or EKumm@mdausa.org for more information or questions regarding registration with the Muscular Dystrophy Association and how to become involved.

Julie Lyne, PT

Julie Lyne graduated with a Master's degree in Physical Therapy from the University of Wisconsin-Madison. She has expertise in both orthopedic and neurological outpatient therapy and has been employed at Dean since 2005. Julie strives to provide exceptional patient-centered care for those with neuromuscular disorders by addressing impairments to mobility and comfort through adaptive exercise, positioning, assistive devices and caregiver training. For more information about Dean Physical Therapy, please visit our Physical Therapy section.

Angela Pritzl, PT

Angela graduated with her doctorate in physical therapy from Concordia University of Wisconsin. She has interests in both orthopedic and neurological physical therapy. Angela has been employed at Dean Clinic since 2007. She is currently seeking certification to provide evaluations for manual and power wheelchairs, and other assistive technology. For more information about Dean Physical Therapy, please visit our Physical Therapy section.

Connie Schultz, MS, CGC

Connie is a board certified genetic counselor who received her Masters degree in Medical Genetics from the University of Wisconsin Madison. She has Bachelor of Science degrees in Biology and Psychology from the University of Wisconsin - River Falls. Connie has worked as part of Dean Clinic Genetics since 1995. She has a special interest in neuromuscular / neurogenetic conditions in addition to her background in Maternal Fetal Medicine / fetal anomalies; thrombophilias, and hereditary disorders.

As a genetic counselor she can help you to make informed, personalized decisions about your genetic health by providing medical information regarding your specific disorder. This includes risks for family members, providing information regarding the availability, accuracy and limitations of genetic testing, as well as the interpretation of genetic test results. Options of prenatal or pre-implantation genetic diagnosis can be reviewed. Additionally she can provide diagnosis specific education materials as well as information regarding support groups and research studies. 

Speech Therapist

Our speech therapist evaluates and treats patients with speech and swallowing concerns. For more information about Dean Speech Therapy, please visit our Speech Therapy section.

Aljan Orthotics

Our partners from Aljan Orthotics evaluate and treat mobility issues with orthotics.

Our Location

Location of the Clinic

Dean’s Multi-disciplinary Neuromuscular Clinic is located within the Dean Neurological Institute and Spine Center, on the third floor of the Dean & St. Mary's Outpatient Center. Our clinic is easily accessible, with free valet parking. For a map and driving directions, please visit the Dean & St. Mary's Outpatient Center page.