Muscle Disorders: Difference between revisions

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== Introduction  ==


== Descripation:  ==
[[Muscle]] Disorders are the diseases and disorders that affect the human muscle system and their main manifestation is skeletal muscle weakness. The terms ‘muscular dystrophy’, ‘neuromuscular conditions’ and ‘neuromuscular disorders’ fall under the umbrella of the term 'Muscle Disorders'. These disorders are a large group of conditions which affect either the muscles, such as those in the arms and legs or heart and lungs, or the nerves which control the muscles<ref name="service" />. Disorders of muscle may cause weakness or paralysis in the presence of an intact nervous system. 


The terms ’muscle disease’, ‘muscular dystrophy’, ‘neuromuscular conditions’ and ‘neuromuscular disorders’ all describe a large group of conditions which affect either the muscles, such as those in the arms and legs or heart and lungs, or the nerves which control the muscles<ref name="muscular">http://www.muscular-dystrophy.org/newly_diagnosed/about_muscle_disease/545_what_is_muscle_disease</ref>. Muscle disease include a number of rare conditions, which in most cases tend to present at around the same age and due to the their progressive character they can lead to physical limitations and reduced life expectancy. <br>
== Classification ==
 
Muscle disorders can be classified on the basis of :
== Causes: ==
# Primary or secondary : Diseases and disorders as a result of direct abnormalities of the muscles are considered primary muscle diseases, Eg. [[Polymyositis]]. And Diseases that are secondary to another condition and may have caused muscle damage, Eg. diseases due to endocrine issues .  
# Genetic or Acquired
# [[Neuromuscular Disorders|Neuromuscular]] or [[Myopathies]] 
== Etiology ==


Causes of muscle disorders include<ref name="service">A service of the U.S. National Library of Medicine. From the National Institutes of HealthNational Institutes of Health http://www.nlm.nih.gov/medlineplus/muscledisorders.html</ref>:  
Causes of muscle disorders include<ref name="service">A service of the U.S. National Library of Medicine. From the National Institutes of HealthNational Institutes of Health http://www.nlm.nih.gov/medlineplus/muscledisorders.html</ref>:  


*Age, hereditary
*Injury or overuse, such as sprains or strains, cramps or tendinitis  
*Injury or overuse, such as sprains or strains, cramps or tendinitis  
*A genetic disorder, such as muscular dystrophy  
*A genetic disorder, such as muscular dystrophy  
*Some cancers  
*Some cancers  
*Inflammation, such as myositis  
*Inflammation, such as [[Myositis Ossificans of the Quadriceps|myositis]]
*Diseases of nerves that affect&nbsp;[[Muscle]]
*Diseases of nerves that affect&nbsp;muscle
*[[Infectious Diseases]]  
*[[Communicable Diseases|Infectious Diseases]]  
*Certain medicines
*Certain medicines
*[[Metabolic and Endocrine Disorders|Metabolic causes]] and Endocrine causes
*[[Autoimmune Disorders|Autoimmune]] disorders
*Etiology may not be known at times


Sometimes the cause is not known.<br>
== Symptoms  ==
 
== Symptoms: ==
 
Symptoms vary with the different types of muscular dystrophy.<br>All of the muscles may be affected. Or, only specific groups of muscles may be affected, such as those around the pelvis, shoulder, or face. Muscular dystrophy can affect adults, but the more severe forms tend to occur in early childhood.
 
<br>'''Symptoms include:'''<br>Intellectual disability (only present in some types of the condition)<br>Muscle weakness that slowly gets worse<br>Delayed development of muscle motor skills<br>Difficulty using one or more muscle groups<br>Drooling<br>Eyelid drooping (ptosis)<br>Frequent falls<br>Loss of strength in a muscle or group of muscles as an adult<br>Loss in muscle size<br>Problems walking (delayed walking)<ref name="HB">Sarnat HB. Muscular dystrophies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 601.</ref>
 
== Types:  ==
 
Muscular dystrophy is a group of inherited diseases that are characterized by weakness and wasting away of muscle tissue, with or without the breakdown of nerve tissue. There are nine types of muscular dystrophy, with each type involving an eventual loss of strength, increasing disability, and possible deformity<ref>http://uhealthsystem.com/health-library/neuro/disorder/muscular/musctype</ref>.
 
The most well known of the muscular dystrophies is '''[[Duchenne Muscular Dystrophy|Duchenne muscular dystrophy]] (DMD)''',presently no cure, it occurs genetically, most commonly in children by his/her mother and is the most severe of all the muscular dystrophies. The symptoms first present in 3 to 5 years of age, as progressively joints become stiff and muscles power is lost. Thus, DMD is characterised as severe life-limiting disease requiring multi-disciplinary intervention and life-long management.
 
'''Becker:'''Symptoms are almost identical to Duchenne but condition is milder and progresses more slowly; survival into middle age.
 
'''Congenital:'''Symptoms include general muscle weakness and possible joint deformities; disease progresses slowly; shortened life span.
 
'''Distal:'''Symptoms include weakness and wasting of muscles of the hands, forearms, and lower legs; progression is slow; rarely leads to total incapacity.


'''Limb-Girdle:'''Symptoms include weakness and wasting, affecting shoulder girdle and pelvic girdle first; progression is slow; death is usually due to cardiopulmonary complications.  
Symptoms vary with the different types of muscular disorder.


'''Myotonic:''' Symptoms include weakness of all muscle groups accompanied by delayed relaxation of muscles after contraction; affects face, feet, hands, and neck first; progression is slow, sometimes spanning 50 to 60 years.  
'''Symptoms may include:'''
# Muscle weakness that slowly gets worse.
# breathing issues, especially [[Dyspnoea|dyspnea]] (shortness of breath)
# dizziness,
# Fatigue
# Muscle wasting, loss of strength
# high fever,
# a stiff neck. 
# Numbness, tingling, or painful sensations
# Double vision
# Droopy eyelids
# Problems with swallowing—dysphagia
# Difficulty using one or more muscle groups, muscle weakness,
# Problems walking, balance and frequent [[falls]]<ref name="HB">Sarnat HB. Muscular dystrophies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 601.</ref>


'''Atrophy:''' Spinal Muscular Atrophy is the most common type of muscular atrophies. Several types of the disease are known. More information about SMA can be found [[Spinal Muscular Atrophy (SMA)|here]].  
== Types Of Muscle Disorders  ==
Common types of Muscle Disorders include
#'''[[Myopathies]] eg''' [[Polymyositis|Polymyositis]], [[Dermatomyositis]], [[Duchenne Muscular Dystrophy|Duchenne]] Muscular Dystrophy, [[Myopathy Steroid Induced|Steroid induced myopathy]]
#'''Cramp:''' prolong painful involuntary contraction of skeletal muscles
#'''Fibrositis<nowiki/>:''' Inflammation of fibrous connective tissues in muscles.it also effect muscles of trunk and back.<ref name="ivyrose">ivyrose holistic http://www.ivy-rose.co.uk/HumanBody/Muscles/Muscular_Disorders.php</ref>
#'''[[Myasthenia Gravis]]'''
#'''[[Rhabdomyolysis]]'''
#'''Cardiac Myopathy:'''  [[Coronary Artery Disease (CAD)|Coronary Artery Disease]]  
#'''[[Amyotrophic Lateral Sclerosis]]'''
#'''[[Muscle Function: Effects of Aging|Sarcopenia]]:''' This muscle disease can be primary or secondary. Sarcopenia causes muscle mass loss and muscle strength loss.  


'''Cramp''': prolong painful involuntary contraction of skeletal muscles.
== Diagnosis  ==


'''Fibrositis''': Inflammation of fibrous connective tissues in muscles.it also effect muscles of trunk and back.<ref name="ivyrose">ivyrose holistic http://www.ivy-rose.co.uk/HumanBody/Muscles/Muscular_Disorders.php</ref>
Usually it is first suspected because of symptoms: a muscle weakness is noticed by the patient, family or a doctor.<ref name="simple">Individual &amp; Caretaker Workbook Simple and Easy Instructionshttp://myhealth.patient.co.uk/</ref>  


== Diagnosis: ==
Muscle Disorders may be diagnosed using one or more of the following tests:  
# An electromyography (EMG) - this is a recording of the electrical activity in a muscle. It can diagnose muscle disorders, nerve and motor problems, and degenerative diseases.
# A [[Blood Tests|blood test]] : measuring specific muscle enzymes and antibodies that may be specific to one disorder or many
# A muscle biopsy - this involves taking a small sample of muscle under local anaesthetic. The sample is examined under the microscope and the muscle chemicals (proteins) may be tested.
# Genetic analysis - this involves testing a person's DNA using a [[Blood Physiology|blood]] sample. It can detect many (not all) cases of MD.
# [[MRI Scans|MRI]]: to show abnormal muscle areas
# Muscle ultrasound is used to look for suspected CMD.


Usually it is first suspected because of symptoms: a muscle weakness is noticed by the patient, family or a doctor. Also, if a child has delayed motor milestones (as mentioned above), a doctor may advise testing for MD, even though the problem could be due to another cause.<ref name="simple">Individual &amp; Caretaker Workbook Simple and Easy Instructionshttp://myhealth.patient.co.uk/</ref>
== Treatment  ==


MD may be diagnosed using one or more of the following tests:  
There is currently no cure for muscular disorders, but a variety of treatments can help manage the condition.<ref name="nhs">http://www.nhs.uk/Conditions/Muscular-dystrophy/Pages/Treatment.aspx</ref>&nbsp;The goals of treatment for muscle diseases may include:
# treating symptoms, 
# delaying disease progression, and 
# improving quality of life.
'''Medical Management'''


A blood test for creatine kinase (CK) - in many types of MD, the blood level of CK is very high.<br>A muscle biopsy - this involves taking a small sample of muscle under local anaesthetic. The sample is examined under the microscope and the muscle chemicals (proteins) may be tested.<br>Genetic analysis - this involves testing a person's DNA using a blood sample. It can detect many (not all) cases of MD.<br>An electromyogram (EMG) - this is a recording of the electrical activity in a muscle.<br>Muscle ultrasound is used to look for suspected CMD.
[[Corticosteroid Medication|Corticosteroids]] taken by mouth are sometimes prescribed for reducing cramping and spasms. Immunosuppressants—drugs inhibit or prevent the overactivity of the immune system—may be given for some muscle and nerve diseases, and conditions that affect both the nerves and muscles.
* Surgical corrections may be advised if needed.
* The person should be as active as possible. Complete inactivity (such as bedrest) can make the disease worse.<ref name="RF">Bushby RF, Birnkrant DJ, Case LE, Clemens PR, Cripe L, Kaul A, et al. Diagnosis and management of Duchenne muscular dystrophy. Lancet Neurol . 2010;9:77-93. http://www.nytimes.com/health/guides/disease/muscular-dystrophy/overview.html</ref>


== Treatment:  ==
== Physiotherapy Management ==
The physical therapist is part of multidisciplinary team and management of such disorders is long-term.


There is currently no cure for muscular dystrophy (MD), but a variety of treatments can help manage the condition.<ref name="nhs">http://www.nhs.uk/Conditions/Muscular-dystrophy/Pages/Treatment.aspx</ref>&nbsp;low-impact exercise, such as swimming<br>physiotherapy can be useful for maintaining muscle strength, preserving flexibility and preventing stiff joints<br>physical aids, such as a wheelchair, leg braces or crutches, can help you maintain standing and stay mobile.
The Physical therapy goals may include:
 
* Strengthening programme 
Corticosteroids taken by mouth are sometimes prescribed to children to keep them walking for as long as possible.<br>The person should be as active as possible. Complete inactivity (such as bedrest) can make the disease worse.<ref name="RF">Bushby RF, Birnkrant DJ, Case LE, Clemens PR, Cripe L, Kaul A, et al. Diagnosis and management of Duchenne muscular dystrophy. Lancet Neurol . 2010;9:77-93. http://www.nytimes.com/health/guides/disease/muscular-dystrophy/overview.html</ref>
* [[Pain-Modulation|Pain]] Management
 
* Management of contractures: [[stretching]], exercises and night splints, if required
== Management ==
* Swimming and [[Aquatherapy|hydrotherapy]]
 
=== General management ===
* Arranging home adaptations  
* Arranging home adaptations  
* Management of contractures: stretching, exercises and night splints.
* [[Cardiac Rehabilitation|Cardiac]] and [[Respiratory Muscle Training|Respiratory]] Rehabilitation programme
* Corticosteroids
* [[Balance Training|Balance training]]<br>  
* Swimming and hydrotherapy
== Reference  ==
* Surgical corrections
 
=== Respiratory and Cardiac problems ===
With advancing age, respiratory and cardiac problems will become inevitable and if not recognised early, can become cause of death. Muscle weakness can affect the intercostal and diaphragmatic muscles, and thus the a reduction in vital capacities are expected. Some of the symptoms are chest wall stiffness, recurrent aspiration and inability to cough. There is evidence that nocturnal ventilation and spinal surgery further improve survival<ref>Eagle et al., 2007 Managing duchenne muscular dystrophy - the additive effect of spinal surgery and home ventilation in improving survival.</ref>.
 
== Prevention:  ==
 
Genetic counseling is advised when there is a family history of muscular dystrophy. Women may have no symptoms but still carry the gene for the disorder. Duchenne muscular dystrophy can be detected with about 95% accuracy by genetic studies performed during pregnancy<ref name="HB" />
 
<br>  
 
== Reference: ==
<references />
<references />


[[Category:Neurological Conditions]]  
[[Category:Neurological - Conditions]]  
[[Category:Muscular Dystrophy]]  
[[Category:Muscular Dystrophy]]  
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Paediatrics]]
[[Category:Occupational Health]]
[[Category:Occupational Health]]
[[Category:Physiology]]
[[Category:Genetic Disorders]]

Latest revision as of 07:18, 5 March 2022

Original Editor - Elaine Lonnemann

Top Contributors -Andeela Hafeez, Kim Jackson, Rucha Gadgil, Elaine Lonnemann, Evelin Milev, Admin, Lucinda hampton, 127.0.0.1, Wendy Walker, Evan Thomas, Anil pratap tanwar, Vidya Acharya and Amrita Patro  

Introduction[edit | edit source]

Muscle Disorders are the diseases and disorders that affect the human muscle system and their main manifestation is skeletal muscle weakness. The terms ‘muscular dystrophy’, ‘neuromuscular conditions’ and ‘neuromuscular disorders’ fall under the umbrella of the term 'Muscle Disorders'. These disorders are a large group of conditions which affect either the muscles, such as those in the arms and legs or heart and lungs, or the nerves which control the muscles[1]. Disorders of muscle may cause weakness or paralysis in the presence of an intact nervous system. 

Classification[edit | edit source]

Muscle disorders can be classified on the basis of :

  1. Primary or secondary : Diseases and disorders as a result of direct abnormalities of the muscles are considered primary muscle diseases, Eg. Polymyositis. And Diseases that are secondary to another condition and may have caused muscle damage, Eg. diseases due to endocrine issues .
  2. Genetic or Acquired
  3. Neuromuscular or Myopathies

Etiology[edit | edit source]

Causes of muscle disorders include[1]:

  • Age, hereditary
  • Injury or overuse, such as sprains or strains, cramps or tendinitis
  • A genetic disorder, such as muscular dystrophy
  • Some cancers
  • Inflammation, such as myositis
  • Diseases of nerves that affect muscle
  • Infectious Diseases
  • Certain medicines
  • Metabolic causes and Endocrine causes
  • Autoimmune disorders
  • Etiology may not be known at times

Symptoms[edit | edit source]

Symptoms vary with the different types of muscular disorder.

Symptoms may include:

  1. Muscle weakness that slowly gets worse.
  2. breathing issues, especially dyspnea (shortness of breath)
  3. dizziness,
  4. Fatigue
  5. Muscle wasting, loss of strength
  6. high fever,
  7. a stiff neck. 
  8. Numbness, tingling, or painful sensations
  9. Double vision
  10. Droopy eyelids
  11. Problems with swallowing—dysphagia
  12. Difficulty using one or more muscle groups, muscle weakness,
  13. Problems walking, balance and frequent falls[2]

Types Of Muscle Disorders[edit | edit source]

Common types of Muscle Disorders include

  1. Myopathies eg Polymyositis, Dermatomyositis, Duchenne Muscular Dystrophy, Steroid induced myopathy
  2. Cramp: prolong painful involuntary contraction of skeletal muscles
  3. Fibrositis: Inflammation of fibrous connective tissues in muscles.it also effect muscles of trunk and back.[3]
  4. Myasthenia Gravis
  5. Rhabdomyolysis
  6. Cardiac Myopathy: Coronary Artery Disease
  7. Amyotrophic Lateral Sclerosis
  8. Sarcopenia: This muscle disease can be primary or secondary. Sarcopenia causes muscle mass loss and muscle strength loss.

Diagnosis[edit | edit source]

Usually it is first suspected because of symptoms: a muscle weakness is noticed by the patient, family or a doctor.[4]

Muscle Disorders may be diagnosed using one or more of the following tests:

  1. An electromyography (EMG) - this is a recording of the electrical activity in a muscle. It can diagnose muscle disorders, nerve and motor problems, and degenerative diseases.
  2. A blood test : measuring specific muscle enzymes and antibodies that may be specific to one disorder or many
  3. A muscle biopsy - this involves taking a small sample of muscle under local anaesthetic. The sample is examined under the microscope and the muscle chemicals (proteins) may be tested.
  4. Genetic analysis - this involves testing a person's DNA using a blood sample. It can detect many (not all) cases of MD.
  5. MRI: to show abnormal muscle areas
  6. Muscle ultrasound is used to look for suspected CMD.

Treatment[edit | edit source]

There is currently no cure for muscular disorders, but a variety of treatments can help manage the condition.[5] The goals of treatment for muscle diseases may include:

  1. treating symptoms,
  2. delaying disease progression, and
  3. improving quality of life.

Medical Management

Corticosteroids taken by mouth are sometimes prescribed for reducing cramping and spasms. Immunosuppressants—drugs inhibit or prevent the overactivity of the immune system—may be given for some muscle and nerve diseases, and conditions that affect both the nerves and muscles.

  • Surgical corrections may be advised if needed.
  • The person should be as active as possible. Complete inactivity (such as bedrest) can make the disease worse.[6]

Physiotherapy Management[edit | edit source]

The physical therapist is part of multidisciplinary team and management of such disorders is long-term.

The Physical therapy goals may include:

Reference[edit | edit source]

  1. ↑ 1.0 1.1 A service of the U.S. National Library of Medicine. From the National Institutes of HealthNational Institutes of Health http://www.nlm.nih.gov/medlineplus/muscledisorders.html
  2. ↑ Sarnat HB. Muscular dystrophies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 601.
  3. ↑ ivyrose holistic http://www.ivy-rose.co.uk/HumanBody/Muscles/Muscular_Disorders.php
  4. ↑ Individual & Caretaker Workbook Simple and Easy Instructionshttp://myhealth.patient.co.uk/
  5. ↑ http://www.nhs.uk/Conditions/Muscular-dystrophy/Pages/Treatment.aspx
  6. ↑ Bushby RF, Birnkrant DJ, Case LE, Clemens PR, Cripe L, Kaul A, et al. Diagnosis and management of Duchenne muscular dystrophy. Lancet Neurol . 2010;9:77-93. http://www.nytimes.com/health/guides/disease/muscular-dystrophy/overview.html
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