• Muscular Dystrophy

    (MD)

    Definition

    Muscular dystrophy is a group of inherited, progressive muscle disorders. All forms cause progressive weakness and degeneration of the muscles that control movement. Some also affect the heart or other organs. Age of onset is between infancy to adulthood. The different forms include:
    • Duchenne dystrophy (the most common)
    • Becker (a milder form than Duchenne)
    • Myotonic muscular dystrophy (can have its onset in late adulthood)

    Causes

    This condition is caused by defects in genes that control muscle development and function. In some cases, the genes are passed from parent to child. In other cases, the genetic mutation occurs spontaneously.

    Risk Factors

    These factors increase your chance of developing muscular dystrophy. Tell your doctor if you have any of these risk factors:
    • Family member with muscular dystrophy
    • Sex: male for some types (Duchenne and Becker)

    Symptoms

    Symptoms common to most forms of muscular dystrophy may include:
    Initial symptoms:
    • Progressive weakening of muscles—Usually, those muscles closest to the trunk become weak first. Then, muscles further away weaken as the disease advances.
    • Enlargement of muscles as they weaken
    • Clumsiness
    • Frequent falling and difficulty getting up
    Later symptoms:
    • Severe muscle deterioration, usually leading to use of a wheelchair
    • Distortion of the body
    • Muscle contraction and stiffening (often severe)
    • Difficulty breathing
    Severe Muscle Contraction of the Hand
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.
    Symptoms specific to Duchenne and Becker dystrophy include:
    • Abnormally curved spine
    • Enlargement and weakening of the heart muscle
    • Pneumonia and other respiratory infections
    Symptoms specific to myotonic muscular dystrophy include:
    • Difficulty in letting go after a handshake
    • Muscle weakness that affects the central nervous system, heart, digestive tract, glands, or eyes
    Symptoms usually become progressively worse. In many forms, life expectancy is shortened.

    Diagnosis

    The doctor will ask about your symptoms and medical history. She will also do a physical exam.
    Tests may include:
    • Muscle tissue biopsy —removal of a sample of muscle tissue for testing
    • Blood enzyme tests—testing a blood sample to look for elevated enzyme levels
    • Genetic testing-using blood samples
    • Electromyogram (EMG) —measures electrical impulses coming from muscles
    • Nerve conduction study (NCS) —measures electrical impulses in the nerves

    Treatment

    There is no cure. However, treatment may help improve the symptoms.
    Treatment may consist of:

    Physical Therapy and Exercise

    Physical therapy and exercise can help prevent the muscles from permanently contracting and stiffening.

    Braces

    In earlier stages, wearing braces may improve your ability to move around. A back brace may slow curvature of the spine.

    Medication

    Medicines may include:
    • Corticosteroids to relieve muscle weakness (chronic steroids can also cause muscle injury called “steroid myopathy”)
    • Creatine supplements (shown to reduce fatigue and increase strength in some studies)
    • Drugs for heart problems if muscular dystrophy affects the heart
    Much research is being done in this area. A new technique called “gene transfer” therapy has been used with some good early results in certain forms of dystrophy.

    Surgery

    In severe cases, surgery may be needed to release muscles that are painfully tight. If there are heart problems, a pacemaker may be needed.

    Prevention

    Muscular dystrophy is an inherited disease. Get genetic counseling if you are concerned about having a child with muscular dystrophy, especially if you:
    • Have muscular dystrophy or a family history of the disease
    • May be a carrier of the gene for muscular dystrophy
    • Have a partner with a family history of the disease

    RESOURCES

    Muscular Dystrophy Association http://www.mdausa.org/

    Muscular Dystrophy Family Foundation http://www.mdff.org/

    Parent Project Muscular Dystrophy http://www.parentprojectmd.org/

    CANADIAN RESOURCES

    Canadian Institute of Health Research http://www.cihr-irsc.gc.ca/

    Muscle Dystrophy Canada http://www.muscle.ca/

    References

    Aartsma-Rus A, den Dunnen JT, van Ommen GJ. New insights in gene-derived therapy: the example of Duchenne muscular dystrophy. Ann NY Acad Sci. 2010;1214:199-212.

    Amato AA, Griggs RC. Overview of the muscular dystrophies. Handb Clin Neurol. 2011;101:1-9.

    Berkow R. The Merck Manual of Medical Information . 17th ed. New York, NY: Pocket; 2000.

    Creatine. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 2008. Accessed March 5, 2008.

    Duchenne muscular dystrophy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 31, 2008. Accessed February 23, 2008.

    Escolar DM, Hache LP, Clemens PR, et al. Randomized, blinded trial of weekend vs daily prednisone in Duchenne muscular dystrophy. Neurology. 2011;77(5):444-452.

    Gene transfer therapy for treating children and adults with limb girdle muscular dystrophy type 2D (LGMD2D). Clinical Trials.gov website. Available at: http://clinicaltrials.gov/ . Accessed September 4, 2011.

    Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine . 16th ed. New York, NY: The McGraw-Hill Companies; 2005.

    Moxley RT, Heatwole C. Myotonic dystrophy. Medlink website. http://www.medlink.com . Accessed March 16, 2007.

    Muscular Dystrophy Association website. Available at: http://www.mdausa.org .

    NINDS muscular dystrophy information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/ . Updated January 27, 2009. Accessed February 6, 2009.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.