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Neuromuscular Laboratory

The Emory Neuromuscular Laboratory, located within the Department of Neurology, processes all nerve and muscle biopsies sent to Emory Medicine.  We are a full service laboratory providing tissue diagnostic services for patients with neuromuscular diseases.

Director:  Jonathan D. Glass, MD.  Professor of Neurology and Pathology.  Board certified in Neurology and Pathology (Neuropathology). 

Laboratory hours: 8:30 a.m. to 5:00 p.m., Monday through Friday.  Technicians are available to accept biopsy specimens from 8:30 to 3:00.  In order to provide the highest quality morphological results, nerve and muscle specimens need immediate attention.  This requires approximately two hours of technician time after the specimen is received in the laboratory.  For this reason, if specimens are to be sent the same day by courier, procedures should be scheduled early in the day so that specimens arrive in our laboratory before 3:00 p.m.  Fridays should be avoided for nerve biopsies due to overnight fixation.

Optimally, fresh tissue specimens should be delivered to our laboratory within four hours of the biopsy procedure.  If the specimen cannot be delivered within 24 hours by overnight courier (either because of geographical location or because of a late Friday biopsy), we have provided detailed instructions on what steps should be taken to insure proper tissue preservation.

It is important that you contact our technicians before sending your biopsy specimen (404-727-3340) so that we know to expect your tissue.

Please fill out the Biopsy Information Sheet and send the completed copy with the specimen.  It is essential that the upper portion be filled out COMPLETELY and CAREFULLY.  Please also provide clinical information concerning your patient, as it is helpful when interpreting the biopsy.  If you cannot provide the clinical history, please be sure to include contact information for the referring physician.  Please also include the names, addresses, and FAX numbers of physicians who should received copies of the diagnostic report.  

Billing:   We cannot bill patients or their insurance companies.  We will bill outside facilities directly.  CPT codes and prices can be supplied upon request.

We are happy to answer any additional questions you may have, or address any areas of concern.  Please do not hesitate to contact us. 

Protocol for Nerve and Muscle Biopsies from Outside Hospitals

The following instructions are provided to ensure proper collection of the biopsy tissue so that subsequent sectioning may be done successfully. Please see the overview presentation for step by step instructions.

Nerve Biopsies

  • A segment of nerve approximately 3 cm to 5 cm should be obtained.  If the specimen is to be sent the same day by courier, carefully wrap the nerve in saline moistened gauze, place in a specimen container, and send on regular crushed ice.  When the nerve must be sent overnight, proceed as follows: 
  • Using fine forceps, carefully grab the nerve by its epineurium only, and pull across a piece of index card to straighten.
  • Place this piece of nerve (it will stick to the note card) face down in a container of 3% buffered glutaraldehyde.
  • Place this container in a Styrofoam cooler of regular crushed ice and send immediately by messenger to the Neuromuscular Laboratory.

Muscle Biopsies

    • The specimen should be at least 2 cm x 1 cm x 1 cm. Please avoid sutures or muscle clamps.
    • Wrap the piece of muscle in saline moistened gauze to prevent the tissue from drying out.
    • The tissue should not be immersed in saline, as this can cause artifact and distortion.
    • Place the tissue in a specimen container and then in a cooler with regular crushed ice. 
    • Preferably, the specimen should be delivered to our laboratory within 4 hours.  If delivery to our laboratory will be within 24 hours, please send the specimen wrapped in saline moistened gauze, in a specimen container placed in a cooler filled with regular crushed ice. 
    If the specimen cannot be delivered within 24 hours, the following procedure should be followed to insure proper tissue preservation:
      • Cut the muscle tissue and place one third into 10% buffered formalin for paraffin processing. 
      • Cut a tiny piece of muscle tissue (5 mm x 2-3 mm) for electron microscopy.  Stretch gently and straighten on a piece of index card and place in 3% buffered glutaraldehyde.
      • Ship these two specimens in fixative on regular crushed ice.
      • Two thirds of the muscle specimen should be frozen as follows:
      • Pour appoximately 100ml of 2-methylbutane (isopentane) into a metal container that will hold a minimum of 200 ml. Surround the container with dry ice to keep it cold. Drop a small piece of dry ice into the liquid and wait until the bubbling has stopped. 
      • Label a piece of cork with the patient ID# and apply a small amount of OCT compound to the cork.
      • Orient the piece of muscle for cross sectioning.
      • Use long handle forceps to hold the cork and completely immerse the tissue into the super-cooled isopentane. 
      • Hold the cork steady for 15 to 20 seconds (depending on the size of the specimen).
      • Wrap the frozen tissue in the piece of aluminum foil labeled with patient identification. 
      • Ship the frozen tissue in a styrofoam container on dry ice

      All specimens should be delivered to:

      EMORY UNIVERSITY SCHOOL OF MEDICINE
      Department of Neurology
      Neuromuscular Laboratory
      Woodruff Memorial Research Building, Room 6310
      101Woodruff Circle
      Atlanta, Georgia  30322
      404-727-3340
      (See directions for couriers below)

      If you have any technical questions about either form of biopsy, you may contact the Neuromuscular Laboratory directly at 404-727-3340.  If you are unable to reach anyone, you may page one of the technicians by dialing 404-686-5500, entering ID # 20007 after the recording, and then entering your return phone number.

      If you would like to obtain an estimate of your invoice, or if you have questions about results, you may contact the Neuromuscular Office, by phone at 404-778-3628 or send an e-mail to us at Marilyn.Thomas@emoryhealthcare.org.

      Directions for Biopsy Specimen Delivery

      The Woodruff Memorial Research Building is located off Clifton Road, beside Emory University Hospital and across the street from the Emory Clinic.  There is a circular drive in front of the building (Woodruff Circle). Take the elevator inside the lobby to the sixth floor.  We are in room 6310.  If you prefer, you may call or page us from the lobby.

      Laboratory room # 6310
      Phone #404-727-3340
      Pager #404-686-5500, ID# 20007