The Allegheny General Hospital Neuromuscular Center provides both inpatient consultative and outpatient clinical care for patients with a variety of neuromuscular diseases throughout the Western Pennsylvania, West Virginia, and greater Eastern Ohio areas. Acute neuromuscular care (i.e., for Guillain-Barré syndrome and acute Myasthenic Crisis) is provided by 24-hour service through our two neuromuscular neurologists. The AGH Neuromuscular Center is composed of two neuromuscular specialists within our 12 physician Department of Neurology associated with the Drexel University School of Medicine. Drs. George A. Small (Neuromuscular Division Director) and Sandeep S. Rana (ALS Director) provide care to our patients with Amyotrophic Lateral Sclerosis (Lou Gehrig's disease), myasthenia gravis, peripheral neuropathy, myopathy, their complications, as well as other conditions. Full diagnostic, therapeutic, and rehabilitative services are available.

• Amyotrophic lateral sclerosis (ALS,Lou Gehrig's disease)
• Primary lateral Sclerosis (PLS)
• Acute polyneuropathy (Guillain-Barré syndrome)
• Myasthenia gravis
• Lambert-Eaton Syndrome
• Inflammatory Myopathy (Polymyositis, Dermatomyositis, Inclusion Body Myopathy)
• Charcot-Marie-Tooth Disease and other congenital and hereditary diseases of the nerve, neuromuscular junction, and muscle
• Toxic Muscle Disease (from medications)
• Peripheral Neuropathy of Diabetes
• Peripheral Neuropathy from nutritional deficiency (vitamin deficiencies)
• Carpal Tunnel Syndrome
• Cervical and Lumbar Radiculopathy
• Tarsal Tunnel Syndrome
• Many others

Drs. Rana and Small also provide treatment of patients with botulinum toxin type-A and type-B for a variety of neurological disorders including spasticity, torticollis, hemifacial spasm, dystonia, as well as chronic pain and headache.

Clinical Specialties

ALS Multidisciplinary Center

• Sandeep S. Rana, M.D. director
• Barbara Swann, M.D., physiatrist
• Phyllis Wanetick, R.N., ALS Center Nurse
• Sherry Patuc, Clinical Coordinator
• Michael Evanek, Neighborcare at Home/Omni Care
• Janra Ranick, Social Worker/Allegheny General Hospital
• Ralph Booker, Klinginsmith Homecare
• Beth Sinteff, Dynavox Systems

ALS Clinic meets the first, third, and fourth Wednesdays every month. This multidisciplinary center supports the ongoing care, diagnosis, and therapy of patients with motor neuron diseases including amyotrophic lateral sclerosis. This multidisciplinary approach with neurology, physiatry, social work, speech therapy, and pulmonary care allows patients with this devastating illness to have comprehensive care in one clinic, at one time.

Research interests of the program include the Amyotrophic Lateral Sclerosis group (ALSRG) collection of data and vital material for tissue banking, facilitating understanding of the cause ALS and related motor neuron diseases.

Studies of the variable human genome in sporadic ALS: a necessary prelude to diagnostics and drug development.

The clinic is recognized by the ALS Association and has treated scores of patients and supported their families during the diagnosis and treatment of ALS.

Peripheral Nerve Center

Drs. George Small and Sandeep Rana specialize in the diagnosis, management, and therapy of patients with a variety of peripheral nerve disorders including diabetic peripheral neuropathy, neuropathy from kidney disease, cancer, nutritional deficiencies, neuropathy related to bariatric surgery, and toxin and medication related neuropathies (chemotherapy related, among other drug treatments). The vast array of available testing in the Neurodiagnostic Laboratory allows accurate workup and expedited diagnosis of common and uncommon peripheral nerve disorders. Working with specialists in endocrinology, general medicine, and orthopedics, as well as neuropathology, the peripheral nerve center at Allegheny General Hospital diagnoses and treats hundreds of patients per year from the tri-state area with these disorders.

Drs. Small and Rana are recognized as local referral center by The Neuropathy Association.

Myasthenia Gravis Center
Drs. Small and Rana treat 100 of the 400 patients in the Western Pennsylvania area with myasthenia gravis and related neuromuscular junction diseases. Diagnosis through the neurodiagnostic laboratory, therapy with IVIG, plasma exchange, steroids, and immunosuppressive therapy, and consideration of thymectomy performed by physicians of the AGH Lung Care Center form the backbone of myasthenia gravis care at AGH. Dr. George Small is an executive committee member of the Myasthenia Gravis Association of Western Pennsylvania and is currently chairman of its Medical Advisory board. (www.mgawpa.org). Dr. Sandeep Rana serves on the Medical Advisory Board of the Myasthenia Gravis Association of Western Pennsylvania.