Center of Excellence in Neuropathy Treatment and Research (CENTR)

At our center, we are dedicated to providing comprehensive care, conducting cutting-edge research, and advancing the understanding and treatment of neuropathy. With an expert team of physicians, healthcare professionals, and researchers, we strive to improve the lives of individuals living with neuropathy and contribute to the development of innovative therapies.

Physician meeting with patient in Neuropathy clinic (2023)
Stephanie Geisler, MD with a patient in the Neuropathy Clinic.

Neuropathy can be a debilitating condition, causing a range of symptoms such as numbness, tingling, pain, and muscle weakness. We understand the challenges and impact this condition can have on your daily life, and we are committed to delivering personalized, evidence-based care to address your unique needs and restore your quality of life. 

Our center is at the forefront of neuropathy research. We are actively exploring new diagnostic techniques and treatment options. Through continued research, we aim to discover the underlying causes of neuropathy and identify novel therapies. Our research not only benefits our patients but also contributes to the broader scientific community’s understanding of this complex condition.

We invite you to explore our website to learn more about our team, services, ongoing research initiatives, and patient resources. Whether you are seeking a diagnosis, exploring treatment options, or interested in participating in clinical trials, we look forward to partnering with you to achieve optimal neurological health and a brighter future.

Our Team

Physicians

Stefanie Geisler, MD

Stefanie Geisler, MD

Assistant Professor of Neurology
Adult, Neuromuscular Medicine


  Geisler lab

 
Top areas of adult care: chemotherapy induced peripheral neuropathy, myopathy/myositis, motor neuron disease
Joshua Newman, MD

Joshua Newman, MD

Assistant Professor of Neurology (PEFA)
Adult, Neuromuscular Medicine

 
Top areas of adult care: ALS, myasthenia gravis, electromyography
Charles (Drew) Roach, MD

Charles (Drew) Roach, MD

Assistant Professor of Neurology (PEFA)
Adult, Neuromuscular Medicine

 
Top areas of adult care: neuromuscular disorders

Physician assistants

Stefanie R. Brier, DMSc, PA-C

Stefanie R. Brier, DMSc, PA-C

Physician Assistant, Neurology

Our Neuropathy Clinic staff 2023

Resources

Community organizations

Flyer of recommended organizations within our St. Louis community.

Neuropathy Clinic Resources thumb
Neuropathy Clinic Resources
Dysautonomia lifestyle recommendations
  • Rise slowly from lying to sitting to standing
  • Drink 2.5 – 3 liters of water per day. Approximately half of this should be electrolyte-rich fluid like Gatorade, Powerade, or dissolvable electrolyte packets
  • Increase salt intake up to 10 grams per day
  • Exercise approximately 30 minutes a day with moderate aerobic activity. Recumbent bike is often well-tolerated in patients with autonomic dysfunction
  • Elevate head of bed with bed rises or cinder block 4-6 inches
  • Eat small meals throughout the day rather than 3 large meals
  • Compression stockings can be purchased online or at your local pharmacy
Dysautonomia work-up

EMG/NCS to query neuropathy. Include SSR, RR variability, and QSART

First tier labs

  • CBC
  • CMP
  • B12
  • Folate
  • TSH, FT4
  • HbA1c
  • ANA, ENA, Lupus anticoagulant
  • B2 glycoprotein
  • IgM/IgG
  • Cardiolipin IgM/IgG
  • C3, C4
  • Mayo dysautonomia paraneoplastic panel

Second tier labs

  • AM cortisol
  • 24 hour urine sodium
  • Serum metanephrines
  • Tryptase
  • 24 hour mast cell mediators (leukotriene E4; 2,3-dinor 11 beta prostaglandin F2 alpha, N-methylhistamine)
  • Orthostatic catecholamines supine and standing

Cardiac testing

  • EKG or Holter
  • TTE

Pathology

  • Lip biopsy and/or skin biopsy

Consults

  • PT for dysautonomia
  • Exercise physiology for POTS
  • Dysautonomia RN educator
  • GI motility consults