Neuromuscular Reference Centre (CRNM)

The Erasme-HUDERF Neuromuscular Reference Centre (CRNM) brings together a multidisciplinary medical and paramedical team with expertise in neuromuscular diseases. Its activities are coordinated by the coordinating physicians, with the support of coordinating nurses and the secretariat. The core medical team, made up of specialists in neurology, paediatric neurology, physical medicine and genetics, works in conjunction with named referral physicians (for paediatric and adult patients) from various specialties (anaesthesiology, cardiology, dermatology, endocrinology, gastroenterology, gynaecology, internal medicine, emergency medicine, obstetrics, ophthalmology, orthopaedics, paediatrics, pneumology, psychiatry, stomatology and urology). This medical team’s expertise enables diagnosis and ensures medical follow-up and treatment during the multidisciplinary neuromuscular consultations held several times a month.

All medical and technical examinations (for example, electromyography, neuromuscular biopsy, DNA analysis and cardiopulmonary assessment) are carried out within the Erasme-HUDERF Neuromuscular Reference Centre. Certain highly specialised laboratory analyses are performed in collaboration mainly with leading laboratories in Belgium and Europe. Neuromuscular biopsies are performed in close collaboration with the neuropathology laboratory of Brugmann University Hospital. The rehabilitation team (present at both the Erasme and HUDERF sites) consists of paramedical specialists representing the following professions: coordinating nurse, occupational therapist, physiotherapist, psychologist, social worker, speech therapist and dietitian.

Patients’ files are systematically discussed during multidisciplinary team meetings, which makes it possible to shorten and refine the diagnostic process and accelerate care. A personalised and coordinated programme of medical and rehabilitation care is systematically proposed to the patient, their relatives and their home care team. There is close collaboration between the CRNM (Erasme site) and the rehabilitation centre located on the same site, which has both inpatient and outpatient facilities where neuromuscular patients are regularly treated during the acute phase and/or over the long term.

Examinations

• Cardiac assessment

  The cardiac assessment as part of the Neuromuscular Reference Centre (CRNM) comprises five examinations: electrocardiogram, echocardiogram, Holter ECG, bone densitometry, and muscle and/or nerve biopsy.

• Electromyography (EMG)

  This examination involves inserting a fine needle into the muscle being studied in order to record the electrical activity produced by the muscle fibres when the muscles are activated or when they are at rest and fully relaxed.

• Cardiopulmonary exercise testing

  Cardiopulmonary exercise testing is used to assess your exercise capacity (cycling). The examination is performed on a bicycle. Measurements are taken throughout the exercise to assess your respiratory system and your heart.

• Nerve conduction velocity testing

  Nerve conduction velocity testing determines the speed at which electrical signals travel along a particular peripheral nerve. It is used to diagnose a nerve injury or dysfunction.

• Evoked potentials

  This technique involves stimulating the sensory organs to assess the function of specialised nerve structures involved in transmitting information related to touch, hearing and vision, using electrical stimuli, headphones and a screen, respectively.

• Repetitive stimulation

  Repetitive nerve stimulation (RNS) is a neurophysiological tool used to reveal certain neuromuscular transmission and muscle conduction deficits.

• Ischaemic forearm exercise test

  The purpose of this test is to detect dysfunctions in muscle metabolism, particularly the muscle’s ability to use energy resources. After a cuff has been inflated around the upper arm and a catheter (a small plastic tube) has been placed in a vein in the forearm, the patient is asked to repeatedly clench their fist against resistance for several minutes.

Treatments 

• Medication

  In the context of neuromuscular diseases, drug treatments are numerous and vary considerably depending on the diagnosis made. It is therefore impossible to detail all the possible options here for the many diseases grouped under the term “neuromuscular diseases”. Each treatment will be adapted with your doctor to your condition and to your individual circumstances (medical history, age, etc.).

• Non-pharmacological treatments

  A significant proportion of patients with a neuromuscular disease experience limitations in their activities of daily living, and the disease often affects various areas of life: professional, family, social, psychological and economic consequences, etc. In this context, the centre’s team offers you integrated, continuous multidisciplinary follow-up over time, in order to identify the difficulties related to the disease as effectively as possible and to try to provide the most appropriate responses according to each patient’s specific needs. Regular physiotherapy is, in most situations, an essential treatment to recover and/or maintain the best possible motor function and functional independence in the medium and long term. A range of measures may be implemented to facilitate daily functioning when necessary: adaptations to the home, various forms of home assistance, different allowances, a reduced-mobility parking permit, etc.

   

On this occasion, the CRNM is organising a symposium on 23 November 2024 at the Museum of Medicine.