Phoenix Neurological Associates

Phoenix Neurological Associates

The Neuromuscular Center at Phoenix Neurological Associates offers state of the art facilities for the performance and processing of muscle and nerve biopsies.

A biopsy is a surgical procedure in which one or more small pieces of muscle or nerve tissue are removed for further microscopic or biochemical examination. The procedure, often used in the diagnosis of a neuromuscular disorder, is considered “minor” surgery and can usually be performed using a local anesthetic. We are able to perform these biopsies in our Neuromuscular Center, so patients do not need to go to a hospital. The procedure takes less than an hour and patients can go home right after the biopsy.

Muscle Biopsy Procedure (24kb PDF)
Nerve Biopsy Procedure (38 kb PDF)
Post Biopsy Instructions (40 kb PDF)

Muscle Biopsy

A doctor is likely to call for a muscle biopsy after looking at preliminary blood tests, performing an electromyogram (EMG) and physical examination, and determining that the patient’s symptoms indicate an underlying neuromuscular disorder. The muscle biopsy can help distinguish between muscular and neurological problems and can help pinpoint the exact neuromuscular disorder present.

The neuromuscular specialist selects a muscle, usually the biceps, triceps, deltoid or quadriceps muscle, that should yield the most information about the disease. Usually, moderately affected muscles are chosen, the weakest muscles may already be too degraded for analysis. The procedure involves a 2-to-3-inch incision, which is then closed with stitches and may feel sore for a few days.

Nerve Biopsy

Most of the time, nerve disorders can be diagnosed without the need for a nerve biopsy. However, a nerve biopsy can be a necessary and valuable test in some patients, such as those suspected of having inflammation of their nerves. As is the case for muscle biopsies, nerve biopsy is an outpatient procedure that can be performed in our Neuromuscular Center.

Analyzing the Sample

All of the biopsies performed in our Neuromuscular Center are processed in our CLIA certified pathology laboratory. This means the samples do not have to be shipped to outside labs. Our highly trained technicians cut them into many thin sections for examination. Using different tests on different sections, we look at the tissue’s overall appearance, chemical activities in the tissue, and the presence or absence of critical proteins. This analysis can yield information about muscle degeneration and regeneration, fiber type abnormalities mitochondrial abnormalities, scar tissue, inflammation and other clues to specific disorders.The information these tests provide helps determine exactly what disease and what form of it the person has.

Finally, a DNA analysis can be performed on a muscle sample to detect a genetic mutation. Although a blood sample is usually adequate for a DNA test, a muscle sample may be needed to test for mitochondrial DNA mutations.

Your doctor may occasionally recommend a new biopsy even though you’ve had one in the past, especially if you’ve been given a tentative diagnosis or now suspect your diagnosis was incorrect. With many new muscle-protein antibodies now available for testing biopsy samples, as well as new understanding of mitochondrial disorders and new DNA tests, a new biopsy may be desirable.

Getting Results

The analysis of a muscle biopsy sample is a very tedious and labor-intensive process in which many sections of the muscle must be cut, many different types of procedures performed, and the results carefully analyzed. Our lab usually performs a few basic histology tests immediately after the biopsy and then, based on these results, determines what further tests should be conducted. The report is usually available within two weeks of the biopsy.

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Notice of Non-Discrimination


Phoenix Neurological Associates complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Phoenix Neurological Institute does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Phoenix Neurological Associates:
  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
    • Qualified sign language interpreters
    • Written information in other formats (large print, audio, accessible electronic formats, other formats)
  • Provides free language services to people whose primary language is not English, such as:
    • Qualified interpreters Information written in other languages
If you need these services, contact Robert Chiffelle, COO. If you believe that Phoenix Neurological Associates has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Robert Chiffelle, COO, 5090 N. 40 St., Suite 250, Phoenix, Az. 85018, Telephone number 602-258-3354, Fax 602-258-3368, Rchiffelle@pnal.net. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Robert Chiffelle, COO is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Anuncio de No Discrimina

Phoenix Neurological Associates cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. [Name of covered entity] no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo. Phoenix Neurological Associates:
  • Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes:
    • Intérpretes de lenguaje de señas capacitados.
    • Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos).
  • Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes:
    • Intérpretes capacitados.
    • Información escrita en otros idiomas.
Si necesita recibir estos servicios, comuníquese con Robert L. Chiffelle, COO. Si considera que Phoenix Neurological Associates no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Robert Chiffelle, COO, 5090 N. 40 St., Suite 250, Phoenix, Az. 85018, Telephone number 602-258-3354, Fax 602-258-3368, Rchiffelle@pnal.net. Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo, Robert L. Chiffelle, COO está a su disposición para brindársela. También puede presentar un reclamo de derechos civiles ante la Office por Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Puede obtener los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html.

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