Wednesday, November 4, 2020

MUSCULAR DYSTROPHY

 

MUSCULAR DYSTROPHY

INTRODUCTION

The term muscular dystrophy refers to a group of inherited muscle-destroying diseases that cause progressive degeneration of skeletal muscle.

 

SIGN AND SYMPTOMS

Signs and symptoms vary with every type but some common are

progressive muscular wasting,

drooping eyelids, atrophy,

Scoliosis,

Inability to walk, frequent falls,

limited range of movement,

respiratory difficulty, joint contractures,

cardiomyopathy, arrhythmias,

muscle spasms,

gowers' sign. [2]

 

CLINICAL STAGES OF MUSCULAR DYSTROPHY

Stage 1: Early/pre-symptomatic

Stage 2: Early ambulatory (Walking)

Stage 3: Late Ambulatory (going off feet)

Stage 4: Early non-ambulatory

Stage 5: Late non-ambulatory

Stage 6 Palliative Cares / End of Life. [3]

 

EPIDEMIOLOGY

Duchenne muscular dystrophy is the most common form of MD.

DMD strikes boys almost exclusively. (World wide about 1 in every 3500 male babies)

Age of onset differs with every type.

 

TYPES

A. Duchenne (most common) and Becker

B. Emery-Dreifuss

C. Limb-girdle,

D. Facioscapulohumeral,

E. Distal

F. Oculopharyngeal.

 

ETIOLOGY

Muscular dystrophies are caused by mutations in genes encoding proteins that are essential for normal muscle function.

The main gene associated is Dystrophin gene.

 

ANIMAL MODELS

MOUSE MODEL:mdx mouse(X-chromosome-linked muscular dystrophy)

CANINE MODEL(Golden retriever (GRMD) German shorthaired pointers (GSHPMD)

 

DIAGNOSIS OF MUSCULAR DYSTROPHY

Family history

Blood test

Electromyography

Muscle biopsy

Histopathology

DNA test

Gene sequencing

Magnetic Resonance Imaging

 

PHARMACOLOGICAL APPROACH

Drug treatment

Gene therapy

Stem Cell Therapy

Physical and Occupational Therapy

Psychological, Orthopedic, Respiratory and CardiovascularManagement

Rehabilitation

Ongoing clinical trials of various new therapies for muscular dystrophy.

 

COMPLICATION AND THEIR MANAGMENT

Scoliosis and Contractures

Pulmonary Complications

Cardiac Complications

Obesity.

 

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