The Augusta University ALS Clinic was started in 2004 as a half day clinic each month. It has now grown to a bimonthly full day clinic. Our clinic is ALSA certified clinic which means that we underwent a rigorous certification process. The clinic is a multidisciplinary clinic so that our ALS patient can receive all needed services at a single visit. It is staffed by 2 dedicated ALS specialists, physical therapist, occupational therapist, speech and language pathologists, respiratory therapist, a dietician and representatives from the ALS Association. In addition, we have equipment vendors in the clinic so that patients can get needed equipment during the clinic.
Jump to: Clinics and Disorders Program Team
Neuromuscular Disorders | Neurology
We specializes in diseases affecting muscles and nerves including:
ALS (Amyotrophic lateral sclerosis) - Lou Gehrig’s Disease
Muscular dystrophies
Myasthenia gravis
Neuropathies
Chronic inflammatory demyelinating polyradiculoneuropathy
Other muscle diseases such as polymyositis
Nerve conduction studies
Skin biopsies
Electromyography
Therapeutic treatments
Nerve and muscle ultrasound
Botulinum toxin injections
We use botulinum toxin injections to treat: Cervical dystonia, Hemifacial spasms, Migraine headaches, Spasmodic dysphonia, Spasticity, Focal limb dystonias—Writers cramp, Sialorrhea, Excessive sweating
Therapeutic nerve blocks
Therapeutic nerve blocks can be used to treat:
Joint injections
Non-surgical treatments to help reduce inflammation of the joint and increase movement
Patients suspected of ALS are seen in our neuromuscular clinic by one of our ALS specialists. During the visit, we can do a diagnostic EMG so the diagnosis can be made at the time of the visit. We guarantee that we see all patients suspected of ALS within 1 month.
We specialize in difficult to treat movement disorders requiring botulinum toxin therapy. Our physicians have over 30 years of clinical experience in this area. We have been involved in clinical research studies involving botulinum toxin including the PREMPT that led to the approval of Botox for migraine headaches.
AU has an active program in Myasthenia Gravis. We can fully evaluate patients seen in our clinic for neuromuscular transmission disorders including Myasthenia Gravis and Myasthenic Syndrome. We can do repetitive nerve stimulation and single fiber EMG studies.
We offer all modalities of therapy including, plasma exchange, IVIG, eculizumab as well as standard immunosuppressant therapy. We offer antibody testing and have recently discovered LRP4 and Agrin antibodies which are linked to myasthenia gravis in patients that are negative to standard testing for ACHR and MuSK antibodies.
ALS Research
We have participated in several Basic research projects looking at the etiology of ALS. In the past we looked at the association of LRP4/Agrin antibodies in ALS and SGPG antibodies in ALS. We have just recruited a Basic Researcher, Dr Eric Vitriol who start work in February. He will be looking at the Actin cytoskeleton in ALS. We hope that projects such as this will lead to understanding the cause of ALS which hopefully lead to better treatment for our patients.
Our multi-disciplinary clinic is designed to help our ALS patients throughout all stages of their disease from the initial diagnosis to Hospice care. Our patients have access of all the most recent treatments which have been shown to improve outcome. Our patients have access to clinical trials and basic research projects which hopefully, will one day, lead to a cure.
We have an active clinical research program with 2 full time research associates. Over the years we have participated in numerous ALS Clinical research studies. Currently we are engaged in 3 clinical research studies.
Apellis Study
C3 inhibitor
COMBAT-ALS
Neuroprotective agent (ibudilast)
Anelixis Study
Monoclonal antibody to CD40LG
Myasthenia Gravis Research
We are actively engaged in clinical research in Myasthenia Gravis. Currently we have multiple clinical studies in Myasthenia Gravis.
Alexion Registry Study
This is an observational study for patients getting eculizumab
Takeda Study
This is a monoclonal antibody against CD38
MG0003
This is a monoclonal antibody against the FCRN receptor
Raise Study
This is a monoclonal antibody against C5
Other Clinical Research Studies
Dr. Rivner has over 30 years of experience treating patients with neuromuscular diseases. He is board certified in Neurology, Clinical Neurophysiology and Electrodiagnostic medicine. He graduated Emory University Medical school in 1978 and did his Neurology residency and Neuromuscular fellowship at the Medical College of Georgia. Dr Rivner joined the faculty of Augusta University in 1983. He currently is a Charbonnier Professor Emeritus of Neurology. He is the director of the ALS clinic, EMG lab and Neuromuscular program.
Dr. Barnes received his BA and MD degrees from the University of Kentucky and completed his residency training in Neurology at the same institution in 2019. He did a fellowship in Neuromuscular disease at Duke University and joined the Augusta University Faculty in July 2020. He is board certified in Neurology. His clinical interests include neuromuscular disease and EMG, and his primary research interest is in motor neuron disease. He is the Associate Director of the ALS clinic at AU.
Eric Vitriol, PhD
Dr. Vitriol received his B.S. and Ph.D. from the University of North Carolina at Chapel Hill and did his postdoctoral training at Emory University. He joined the Department of Neuroscience and Regenerative Medicine at Augusta University in February 2021. Dr. Vitriol’s lab studies how the actin cytoskeleton contributes to cell motility, neural development, and in neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS). His ALS research has been supported by funding from the National Institute of Health and the ALS Association. Ultimately, Dr. Vitriol’s goal is to identify and target the cellular mechanism that cause ALS.
Diane Manghram, RN, ACNP, DNP
Dr. Manghram received her Doctor of Nursing Practice in from the Medical College of Georgia, BSN and MS from the University of South Florida. She has over 25 years of clinical acute, critical, medical-surgical, and neurology nursing with further interests in neuromuscular disease and neuromuscular research. Dr. Manghram joined the Neuromuscular section in 2016 as a Neuromuscular Nurse Practitioner in the Department of Neurology, Augusta University Medical Center.