Outpatient Clinics - MED - Neurology Department, University of Minnesota

The continuity clinic experience is one of the most valued aspects of our program. Through this clinic, residents gain experience in the longitudinal care of patients. Each resident is assigned to a single continuity clinic that they maintain throughout the G-1 to G-4 years of training. The clinic meets one afternoon a week, and the resident is excused from all other obligations to attend this clinic. Clinics are staffed by one or more teaching faculty. The supervising faculty remains constant, which facilitates the development of a mentoring relationship between resident and staff. Clinics are provided at UMMC, HCMC, VAMC, and Riverside Hospital.

The University of Minnesota Ataxia Clinic was established in 1991 as a specialty clinic devoted to the diagnosis, treatment, and management of ataxias. The University of Minnesota Ataxia Clinic sees all patients presenting with progressive problems of gait and balance, falling, or vertigo. The founding principle of the UM Ataxia clinic is that patients with any of several rare disorders, most typically degenerative in nature, can benefit from the cumulative and enlarging experience of specialists devoted to the diagnosis and treatment as well as prevention and management of complications of this group of patients. The Ataxia Clinic receives referrals predominantly from internists and neurologists in the Twin Cities area. However, patients are regularly referred from adjoining Midwest states and from throughout the US and continent. Occasional referrals have come from the Middle East, Asia and South America. Currently, 700 patients and relatives have been entered into the database. The Ataxia Clinic is staffed by three Neurology specialists and a triage nurse, and assisted by a team of allied care providers in several fields including Physical Medicine and Rehabilitation, Orthopedics, Ophthalmology, Otolaryngology, Cardiology, and genetic counseling.

A botulinim toxin injection clinic takes place twice a month at HCMC. Cervical dystonia, spasticity, hemifacial spasms, blepharospasm, bruxism, oromandibular dystonia, hyperhidrosis, and intractable headaches are treated with chemodenervation. A separate voice botox clinic for the treatment of spasmodic dysphonia is offered thorough the ENT department at HCMC twice monthly.

The Dementia Clinic is held once a week at the GRECC at VAMC, and provides longitudinal, comprehensive care to dementia patients. More than 300 current patients are part of the GRECC cohort with the majority representing Alzheimer’s Disease, but also patients with Frontotemporal Dementia, Lewy Body Dementia, Corticobasal Degeneration, and Primary Progressive Aphasia, among others.

Multiple movement disorders clinics are held weekly at UMMC, with a special emphasis on Parkinsonian syndromes and dystonia. The multidisciplinary Huntington’s Disease clinic, a nationally recognized center of excellence, meets once a month at HCMC. Research protocols are executed at UMMC and HCMC, including a surgical program at UMMC.

The MS Clinic was established in 2004 and currently follows nearly 1000 patients with all forms of MS and related CNS auto-immune diseases such as neuromyelitis optica (Devic’s disease), idiopathic transverse myelitis, idiopathic optic neuritis, Susac’s syndrome and CNS vasculitis. A neurology resident is currently assigned to the clinic each week on Wednesday morning and is assigned to evaluate all new patients and selected established patients. Resident electives are also available. Many MS patients are enrolled in clinical research trials and interested residents are encouraged to participate in MS research activities and to attend national and international conferences.

There is an MDA-sponsored neuromuscular program at UMMC, which conducts clinics several times a week. A separate neuromuscular clinic is held once a week at HCMC, and at VAMC. An ALSA-certified ALS clinic meets once a week at HCMC, and a large ALS clinic also convenes weekly at UMMC. Adults and children with a wide range of muscle, nerve, and motor neuron disorders are cared for in these clinics. Multidisciplinary care is emphasized. Many of these patients also participate in clinical research trials designed to advance the care of patients with neuromuscular disease.

Subspecialty clinics include Autism (Monday and Tuesday Mornings), ADHD (Friday Afternoon), Brain Tumor (Tuesday Afternoon once monthly), and Neuropsychology (daily). General Child Neurology meets Monday, Tuesday and Thursday afternoons and includes patients with neurologic complaints in the setting of complex pediatric illnesses (i.e. organ transplant, cystic fibrosis, diabetes), neurogenetic disorders, epilepsy, headache, and a large segment of patients with lysosomal or peroxisomal disorders that are treated with enzyme infusions and/or stem cell transplant.

The University of Minnesota and the HCMC Sleep Center have a long history of major contributions in sleep disorders, with most notable the introduction of REM Behavioral Disorder as a new nosologic entity. Sleep clinics are held daily at HCMC, through the Minnesota Regional Sleep Disorders Center run by the neurology department. This program is one of the busiest sleep programs in the country, administering care to more than 2,300 outpatients yearly. Sleep clinics are also held at UMMC.

A multidisciplinary stroke clinic is held twice a month at HCMC and weekly at UMMC, providing long-term care to patients with cerebrovascular disease, including TIAs, ischemic and hemorrhagic stroke, vascular malformations and aneurysms. Active stroke research trials are coordinated through this clinic.

This is one of the most popular specialty clinics for our residents. Coordinated through the Department of Ophthalmology, neurology residents are well received and taught the fundamentals of the neuro-ophthalmologic exam by experts in the field. Novel techniques, such as OCT, are making this an exciting rotation.