EMG/Neuromuscular Fellowship

In the CNP fellowship, fellows spend the majority of their time developing EMG expertise in addition to rotation to other areas of clinical neurophysiology, including EEG, autonomic disorders, and sleep. Patient care is a critical part of the fellowship and fellows spend approximately two half-days participating in outpatient Neuromuscular clinic where they have the opportunity to diagnose and manage patients with a variety of neuromuscular disorders, in addition to providing inpatient Neuromuscular and electrodiagnostic consultations. This experience is further enhanced through participation in the multidisciplinary Motor Neuron Disorders clinic. There are opportunities to learn skin biopsy procedures for intraepidermal nerve fiber (IENF) quantitative analysis. Opportunities for research are also available and participation in a project during the year is strongly encouraged. Formal didactics include weekly neuromuscular and clinical neurophysiology teaching conferences. Fellows who successfully complete this fellowship are eligible for the American Board of Psychiatry and Neurology Subspecialty qualification in Clinical Neurophysiology.

Clinical Neurophysiology Fellowship
Elizabeth Raynor, MD
eraynor@bidmc.harvard.edu
Phone: 617-667-8130, Fax: 617-667-3175

In this fellowship, as in the CNP fellowship, there is extensive training in performance and interpretation of electrodiagnostic studies (EMG), as well as the evaluation and management of Neuromuscular disorders. In addition to EMG and Neuromuscular clinic sessions weekly, there is a half-day spent in pediatric Neuromuscular/MDA clinic at Boston Childrens Hospital (BCH). As for the CNP fellows, there are opportunities to learn skin biopsy procedures for IENF; additionally, there are opportunities to observe muscle and nerve biopsies and attend a weekly multi-center muscle biopsy conference. All fellows attend the weekly Neuromuscular conference and participate in multidisciplinary Motor Neuron Disorders clinic. Clinical and translational research projects are strongly encouraged. Fellows who successfully complete this fellowship are eligible for the American Board of Psychiatry and Neurology Subspecialty qualification in Neuromuscular Medicine.

Neuromuscular Medicine-EMG Fellowship
Aimee Boegle, MD , PhD
aboegle@bidmc.harvard.edu
Phone: 617-667-8130, Fax: 617-667-3175

Our devoted, board-certified team specializes in diagnosing and treating diseases affecting muscle and nerve function, including:

• Amyotrophic lateral sclerosis (ALS) and other diseases of motor neurons
• Inherited and acquired neuropathies, including Guillain-Barre Syndrome
• Myasthenia gravis and disorders of the neuromuscular junction
• Muscular dystrophies and myopathies

In addition to physician consultations, the Neuromuscular Division at BIDMC offers comprehensive neurodiagnostic studies such as:

• Nerve conduction studies and electromyography (EMG)
• Nerve and muscle biopsy
• Neuromuscular ultrasound
• Autonomic Testing and skin biopsy

Specialty Clinics/Services

Multidisciplinary ALS Clinic: For patients diagnosed with ALS, a team approach to treatment is essential. The multidisciplinary ALS clinic at BIDMC allows for convenient access to a wide variety of providers including our neurologists, speech and physical therapist, and social workers. In addition to the latest treatments, patients have the opportunity to participate in clinical trials aimed at developing the next generation of ALS therapies.

Botulinum Toxin Therapy: Treatment for patients with spasticity related to neuromuscular disease.

The Neuromuscular Division in the Department of Neurology at Beth Israel Deaconess Medical Center has an active research program concentrating on human and translational studies. A strong focus of our research is on the development of improved technologies for the initial assessment and monitoring of neuromuscular disease, including the development of the technique of electrical impedance myography (EIM) for the non-invasive evaluation of muscle condition. Research into this modality as well as quantitative ultrasound are ongoing and include clinical studies, basic animal research, and well computer modeling. Ongoing collaborations with researchers and Boston Children’s Hospital, the Massachusetts Institute of Technology, Massachusetts General Hospital, as well as with researchers in other parts of the country helps ensure a dynamic and innovative research program.

In addition to these technological efforts, the division is involved in clinical trials research in amyotrophic lateral sclerosis and previously in autoimmune myositis. Other therapy-focused work is also underway, in both animals and humans, including studies in spinal muscular atrophy, muscular dystrophy, and muscle disuse.

The division has also been focused on patient centered outcomes research and ongoing efforts for improving and applications for these methods across the neurological field are being pursued. This includes development of evidence and consensus based practice guidelines, and research in methods of dissemination of guidelines.

The division’s research is supported by a number of governmental grants (mainly from the National Institutes of Health and NASA), foundations, and to a lesser extent, industry.

Seward Rutkove, MD
Dr. Rutkove is Chief of the Division of Neuromuscular Disorders in the Department of Neurology at Beth Israel Deaconess Medical Center. Dr. Rutkove’s areas of interest have included the effects of temperature on peripheral electrophysiology, diabetic polyneuropathy, electrical impedance of muscle in neuromuscular disorders, and ultrasonographic analysis of muscle as a biomarker of disease status. His major mark has been in the embodiment of electrical impedance myography as a technique for the assessment of neuromuscular disease.

Elizabeth Raynor, MD
Dr. Raynor specializes in clinical Neuromuscular medicine as well as Clinical Neurophysiology, specifically electromyography (EMG) and electrodiagnosis. She is an Associate Professor of Medicine at Harvard Medical School, the Director of the BIDMC EMG Laboratory, Director of the BIDMC EMG Fellowship training program and directs the Motor Neuron Disorders clinic at BIDMC. Her clinical interests include diagnosis and management of neuromuscular disorders, including special interest in motor neuron disorders.

Pushpa Narayanaswami, MD
Dr. Narayanaswami is a neuromuscular neurologist with an interest in health services research. She completed her initial neurology training in India, followed by a residency and fellowship at the University of Tennessee, Memphis. She is the QI director for the Department of Neurology. Her research interests include development of clinical practice guidelines, disseminations and implementation research, and evaluation of adverse events and medical errors.

Courtney E. McIlduff, MD
Dr. McIlduff cares for patients with general neurologic and neuromuscular conditions. She serves as Director of the Neuromuscular Ultrasound Program at BIDMC. To complement clinical responsibilities, she performs research to develop painless, non-invasive measures of muscle health and helps run clinical trials for individuals diagnosed with disorders including amyotrophic lateral sclerosis (ALS). She really enjoys teaching, and plays an active role in the education of medical students, residents, and fellows.

Aimee K. Boegle, MD, PhD
Dr. Boegle is a neuromuscular neurologist whose clinical interests include the care of patients with neuromuscular disease as well as general neurologic illness. Dr. Boegle serves as the director of the Neuromuscular Medicine Fellowship at BIDMC and works closely with the neurology residents and fellows, promoting neurologic and neuromuscular education.

Applicants must have successfully completed an ACGME-accredited program in neurology, child neurology or a program in one of these specialties that is located in Canada and accredited by the RCPSC. Fellows must provide verification of their level of competency in neurology or child neurology using ACGME or CanMEDS Milestones assessments from the core residency program.