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Duchenne muscular dystrophy

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1 Duchenne muscular dystrophy on Sun Oct 02, 2011 8:40 am

avijitprusty

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Duchenne muscular dystrophy is an inherited disorder that involves rapidly worsening muscle weakness.

Causes, incidence, and risk factors

Duchenne muscular dystrophy is a rapidly-worsening form of muscular dystrophy. Other muscular dystrophies (including Becker's muscular dystrophy) get worse much more slowly.

Duchenne muscular dystrophy is caused by a defective gene for dystrophin (a protein in the muscles). However, it often occurs in people without a known family history of the condition.

Because of the way the disease is inherited, males are more likely to develop symptoms than are women. The sons of females who are carriers of the disease (women with a defective gene but no symptoms themselves) each have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers.

Duchenne muscular dystrophy occurs in approximately 1 out of every 3,600 male infants. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy.

Symptoms

Symptoms usually appear before age 6 and may appear as early as infancy. They may include:

Fatigue

Mental retardation (possible, but does not worsen over time)

Muscle weakness

Begins in the legs and pelvis, but also occurs less severely in the arms, neck, and other areas of the body

Difficulty with motor skills (running, hopping, jumping)

Frequent falls

Rapidly worsening weakness

Progressive difficulty walking

Ability to walk may be lost by age 12

By age 10, the person may need braces for walking. By age 12, most patients are confined to a wheelchair.

Signs and tests

A complete nervous system (neurological), heart, lung, and muscle exam may show:

Abnormal heart muscle (cardiomyopathy)

Congestive heart failure or irregular heart rhythm (arrhythmias) -- rare

Deformities of the chest and back (scoliosis)

Enlarged calf muscles, which are eventually replaced by fat and connective tissue (pseudohypertrophy)

Loss of muscle mass (wasting)

Muscle contractures in the heels, legs

Muscle deformities

Respiratory disorders, including pneumonia and aspiration of food or fluid into the lungs (in late stages of the disease)

Tests may include:

Electromyography (EMG)

Genetic tests

Muscle biopsy

Serum CPK

Treatment

There is no known cure for Duchenne muscular dystrophy. Treatment aims to control symptoms to maximize quality of life. Gene therapy may become available in the future.

Activity is encouraged. Inactivity (such as bedrest) can worsen the muscle disease. Physical therapy may be helpful to maintain muscle strength and function. Orthopedic appliances (such as braces and wheelchairs) may improve mobility and the ability to care for yourself.

Expectations (prognosis)

Duchenne muscular dystrophy leads to quickly worsening disability. Death usually occurs by age 25, typically from lung disorders.

Complications

Cardiomyopathy

Congestive heart failure (rare)

Deformities

Heart arrhythmias (rare)

Mental impairment (varies, usually minimal)

Permanent, progressive disability

Decreased mobility

Decreased ability to care for self

Pneumonia or other respiratory infections

Respiratory failure

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