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MYOPATHY. Definition: Myopathies are a group of diseases of the skeletal muscles characterised by gradual progressive degeneration of these muscles. . Clinical Picture:. SYMPTOMS: 1- Clumsy gait. 2- Inability to climb the stairs. 3- Protuberant abdomen.
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Definition: Myopathies are a group of diseases of the skeletal muscles characterised by gradual progressive degeneration of these muscles.
SYMPTOMS: 1- Clumsy gait. 2- Inability to climb the stairs. 3- Protuberant abdomen. 4- Weakness and wasting of certain muscles (shoulder and pelvic girdles and trunk).
5-There is selectivity of the involved muscles. 6- E.C.G. changes, histological changes in the heart and cardiomyopathy may be found specially in Duchennc type. 7-No sensory changes, fasciculations or sphincteric disturbances.
Clinical types of progressive muscular dystrophies 1. Shoulder girdle types: - Scapulo-humeral type. - Facio-scapulo-humeral type. 2. Pelvic girdle types: a)-Pseudo-hypertrophic type: ( Duchenne &Becker). b)-Atrophic type.
3- Other rare types: • Distal type of Gower. • Ocular type. c) Oculo-pharyngeal type.
Wasting shoulder girdle Wasting pelvic girdle Pseudohypertrophy of calf muscles
GENETICALLY MUSCULAR DYSTROPHIES 1-X-linked pseudohypertrophic types: 2- Autosomal dominant:Facio-scapulo-humeral type. 3- Autosomal recessive: Limb girdle type.
INVESTIGATIONS 1- Estimation of creatine and creatinine in urine. 2- Estimation of serum enzyme. 3- Creatine tolerance test. 4- E.M.G. 5- Muscle biopsy.
TREATMENT There is no specific treatment;management is supportive: 1- A.T.P. 25 mg daily I.M. 2- Vitamin E as it helps the retention of creatine in the body. 3- Physiotherapy
Causes of death in muscle dystrophies I- Paralysis of respiratory muscles. II- Infections specially hypostatic pneumonia. III- Cardiomyopathy in Duchenne type.
Myasthenia Myasthenia gravis: It is a disorder of transmission at the neuromuscular junction, manifesting itself clinically by easy fatiguability of the skeletal muscles,
AETIOLOGY: - It is an auto-immune disease.
Myotonia • DEFINITION: Myotonic phenomenon is delayed relaxation of the skeletal muscles after voluntary, mechanical or electrical stimulation.