Grove Neurology
Andrew M. Lerman, MD & Mirla Avila, MD, FAAN
Adult Neurology, Neuroimmunology and Neurophysiology located in Coconut Grove, Coral Gables and Miami, FL
Autoimmune diseases in neurology occur when the body's immune system mistakenly targets components of the nervous system, leading to a wide range of neurological symptoms. Among the most common and complex autoimmune neurologic conditions we treat are Myasthenia Gravis (MG), Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Neuromyelitis Optica Spectrum Disorder (NMOSD), and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). These disorders can cause weakness, fatigue, numbness, vision loss, and functional impairment, but with early and accurate diagnosis, many patients experience significant improvement and long-term stability. At our practice, we specialize in the diagnosis and management of these complex conditions through a personalized approach that may include advanced antibody testing, immunotherapy, physical rehabilitation, and long-term monitoring.
Autoimmune Neurology
Myasthenia Gravis is a chronic autoimmune condition that disrupts communication between nerves and muscles, leading to muscle weakness—especially in the eyes, face, throat, and limbs. Symptoms often worsen with activity and improve with rest. It is treatable with medications such as acetylcholinesterase inhibitors, corticosteroids, immunosuppressants, and in some cases, surgical removal of the thymus gland.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a neurological disorder characterized by progressive weakness and sensory loss in the limbs. It is caused by immune-mediated damage to the myelin sheath surrounding peripheral nerves. CIDP is treatable with immunomodulatory therapies such as corticosteroids, IVIG (intravenous immunoglobulin), or plasma exchange.
Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare autoimmune condition in which the immune system attacks the optic nerves and spinal cord, causing episodes of vision loss, limb weakness, and sensory disturbances. Most patients test positive for the AQP4-IgG antibody, which helps distinguish NMOSD from Multiple Sclerosis. NMOSD is treatable with long-term immunosuppressive therapies, including FDA-approved monoclonal antibody treatments specifically developed for this condition.
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is a distinct autoimmune condition in which antibodies attack MOG, a protein found on the surface of myelin in the central nervous system. It can affect the optic nerves, spinal cord, and brain, presenting as optic neuritis, transverse myelitis, or brain inflammation. MOGAD is diagnosed through specialized MOG-IgG antibody testing and is managed with immunotherapy tailored to whether the patient has a single episode or a relapsing course.
Diagnosis involves a detailed clinical exam, blood tests for specific autoantibodies, electrodiagnostic studies (EMG/NCS), and sometimes imaging or lumbar puncture. Early diagnosis is key to preventing long-term damage.
While autoimmune neurological disorders are typically not curable, many are highly manageable with treatment. With the right therapy plan, many patients experience symptom control and improved quality of life.
Depending on the condition and severity, treatments may include medications to suppress or modulate the immune system, physical therapy, IVIG, plasma exchange, or surgical interventions. Our team creates individualized treatment plans to address each patient’s unique needs.
During your first visit, you will undergo a comprehensive neurological evaluation. We will review your medical history, conduct a physical and neurological exam, and discuss next steps—whether that involves lab testing, imaging, or starting a treatment plan tailored to your symptoms and diagnosis.
