Access to state-of-the-art
testing and expertise

The most trusted muscle and nerve
laboratory in the U.S.

In our consultative practice, we are committed to providing the highest quality neuromuscular pathology consultation. Our highly specialized service allows for the comprehensive diagnosis of nerve and muscle disorders, including inflammatory and non-inflammatory neuropathies and myopathies, degenerative disorders, dystrophies, congenital myopathies, inherited neuropathies, and other causes of peripheral neuropathy.

Unparalleled expertise

Our consultations are performed by experts who see thousands of biopsies specific to neuromuscular disease each year. Our biopsies are performed manually, requiring personal and technical involvement. This unique expertise, highly specialized training, and manual performance provides the highest-quality interpretation and results.

Integrated access to in-house genetic, biochemical and serologic confirmatory testing

Not only is our testing supported by experts, we also have access to the largest available test menu specific to neurology. Our highly specialized test menu provides answers for everything from the simplest to the most complex cases — and much of this testing is not available anywhere else.

Consultative services

Muscle biopsy

Muscle biopsies play an integral role in evaluation of patients with
neuromuscular disease.


Muscle biopsies are useful for:

  • Assessing a patient with suspected muscle disease
  • Identifying treatable muscle diseases (e.g. myositis)
  • Characterizing a specific muscle disease (e.g. type of myositis, congenital myopathy, muscular dystrophy, mitochondrial myopathy, etc.)
  • Guiding genetic testing for inherited muscle diseases
  • Helping interpretation of genetic findings in muscle diseases

MBX | Muscle Pathology Consultation

Nerve biopsy

Nerve biopsies provide information about nerve fibers and the interstitium of the nerve. Neuropathic abnormalities include decreased density of myelinated fibers, segmental demyelination, and axonal degeneration.

Nerve biopsies are important in diagnosing several conditions, including:

  • Necrotizing vasculitis (e.g., large arteriole and microvasculitis)
  • Amyloidosis (e.g., ATTR, wild TTR, AL, gelsolin)
  • Lymphoma
  • Inflammatory demyelinating disease (e.g., CIPD)
  • Infection (e.g., leprosy)
  • Granuloma (e.g., sarcoidosis, perineuritis)
  • Nerve tumors (e.g., perineurioma)

PNBX | Peripheral Nerve Pathology Consultation

Skin biopsy

Small fiber peripheral neuropathy is a common neurological complaint and a frequent source of morbidity in many patient populations. Direct investigation of small fiber involvement has been limited as most classical techniques such as electromyography, nerve conduction studies, and nerve biopsy focus on large-diameter nerve fibers and may be normal in patients with small fiber neuropathies.


Skin biopsies are used to:

  • Identify reduction in the numbers of small sensory nerve fibers
  • Assess reinnervation (e.g., transplanted skin)
  • Identify infection (e.g., leprosy)
  • Diagnose infiltration (e.g., amyloidosis)
  • Our skin biopsies are performed manually, requiring personal and technical involvement, which ensures high-quality and accurate reporting

SPBX | Epidermal Nerve Fiber Density Consultation

Learn more about how to order these evaluations at your institution.