Neuromuscular - Royal North Shore Hospital

The Neuromuscular Clinic caters for adults (> 16 years) with hereditary, metabolic and acquired muscle and nerve disorders. We aim to enable access to comprehensive investigations as required, and patient-centred management in conjunction with the referring clinician. 

• Hereditary muscle diseases – e.g. Muscular dystrophies, metabolic myopathies, channelopathies (periodic paralysis, myotonias), congenital myopathies, congenital myasthenic syndromes.
• Acquired muscle diseases – e.g. Inclusion body myositis, autoimmune myositis, myasthenia gravis
• Hereditary neuropathies, motor neuronopathies – e.g. Charcot Marie Tooth disease, Hereditary motor and sensory neuropathies, Spinal muscular atrophy
• Acquired nerve disorders, motor neuronopathies – e.g. CIDP, motor neuron diseases

• Relevant images/scans/blood test (CK) results (including CT or MRI scan of affected area
• Relevant test results (including nerve conduction studies/ EMG, muscle biopsy report if you have had them)
• List of current medications and drug allergies
• Your referral letter from your GP/Specialist
• Your Medicare/DVA Card 

Your GP or non-GP specialist is always your first step in seeking treatment for any condition. You will be referred to our service if your treating doctor feels that your treatment requires the input of  the Neuromuscular clinic. Once we receive the referral it will be reviewed by a doctor and you will be notified of the outcome and next steps. Please allow at least 4 weeks for this process to be undertaken. We see patients either face to face or via telehealth - your specialist will let you know what the best option is for you.   

Please note that phone calls from the hospital will appear as a blocked number.   Please answer our call if you can and/or turn on voicemail to allow us to leave you a message.  

If you have a scheduled appointment you will receive a reminder text message.   

Please allow a full morning or afternoon for your appointment. Some patients require a longer review and delays can occur. 

To ensure that our resources are directed towards those in most need we have a selection criteria to determine what problems can be seen in our clinic. The below information is mainly for GPs and other referring clinicians.

Please provide the following information in referral: 

•    Patients name, date of birth, address, contact numbers, e-mail address
•    Reason for referral (including a suspected neuromuscular condition if known)
•    CK (creatinine kinase) level
•    Relevant past medical history
•    Current medication

If writing a referral letter, please address to Dr Martin Krause and Associates.

**Please consider referral to the emergency department instead if:

•    Rapid progression of weakness - particularly if involves swallowing +/- breathing difficulty; or
•    CK > 15000 U/L
(As wait time for the clinic can be long.)

Inclusion criteria:

•    Hereditary muscle diseases – muscular dystrophies, metabolic myopathies (including recurrent rhabdomyolysis), channelopathies (periodic paralysis, myotonias), congenital myopathies
•    Suspected acquired muscle diseases – inclusion body myositis, autoimmune myositis, myasthenia gravis
•    Hereditary neuropathies, spinal muscular atrophies
•    Acquired nerve disorders/motor neuropathies – chronic inflammatory demyelinating polyneuropathy (CIDP), motor neurone disease

Exclusion criteria:

•    Non-specific pain
•    Non-specific subjective sensory symptoms
•    Non-specific fatigue/ lethargy 

Our team

Christina Liang - Staff Specialist Neurologist

Sharon Leaver - Neuromuscular Clinic nurse/ coordinator

The Neurology/ Neurophysiology Fellow - Senior Neurology trainees

Clinics - Muscular Dystrophy NSW (mdnsw.org.au)