Presentation
The most common type of nemaline rod myopathy presents in the infantile stage with 42% of patients presenting in the neonatal period. [6] While there has been an association with polyhydramnios, decreased fetal movements, and an abnormal fetal presentation [emedicine.medscape.com]
Other presentations Autosomal recessive (and autosomal dominant) inheritance have been described with several different presentations. [slideshare.net]
An oculomotor nerve palsy with limited abduction and some degree of facial palsy are usually present. The Moebius sequence is present in many patients. Epicanthal folds, downslanting lid fissures, and ptosis are frequently seen. [disorders.eyes.arizona.edu]
All were male and presented in early childhood (first decade of life) with generalized hypotonia and muscle weakness. All of them had dysmorphic facies and three had high arched palate. [bioline.org.br]
Superficial reflexes absent Present Microcephaly, MR,Seizures May be present absent Respiratory muscle involvment rare Common Primitive reflex Present Absent Voice Normal Feeble ( Dysphonic) Cardiomegaly Rare Often Autonomic nervous system Not pronounced [dnbpediatrics.com]
Musculoskeletal
- Back Pain
Neck and back pain due to paraspinous muscle weakness, with kyphosis and exaggerated lumbar lordosis, is also common. [sites.google.com]
Fetus
- Reduced Fetal Movement
The antenatal form with arthrogryposis is distinguished by the presence of contractures at birth due to reduced fetal movement as well as various physical anomalies. The severity of symptoms is variable. [checkorphan.org]
Two patients from 1 family exhibited prenatal symptoms with reduced fetal movements, polyhydramnios, and hydrops. Most showed delayed motor development and difficulty running in childhood; some patients also reported limited walking distances. [bio2rdf.org]
fetal movement. [2] Also muscle abnormalities could lead to a reduction of fetal movement. [en.wikipedia.org]
Clinical description Presentation of MmD is usually in infancy or childhood with hypotonia or proximal weakness; prenatal onset with reduced fetal movements and polyhydramnios has also been recognized [7,8]. [ncbi.nlm.nih.gov]
Clinical description Presentation of MmD is usually in infancy or childhood with hypotonia or proximal weakness; prenatal onset with reduced fetal movements and polyhydramnios has also been recognized [ 7, 8 ]. [ojrd.biomedcentral.com]
Face, Head & Neck
- Short Neck
* Short neck Prevention - Minicore myopathy- antenatal onset- with arthrogryposis Not supplied. [checkorphan.org]
This form is also associated with a range of physical features including long head, low set ears, and a short neck. The respiratory muscles can be moderately to severely affected, thus problems with breathing are common. [musculardystrophyuk.org]
Flat, retractile thorax Cleft soft palate Webbed short neck, hypertelorism Radioulnar synostosis Short neck Finger ulnar deviation, bilateral camptodactyly Low-set ears Parents age at last echocardiogram and ECG (years) 51 and 52 53 and 55 49 and 50 [ncbi.nlm.nih.gov]
Other features included dolichocephaly, prominent nasal root, oblique palpebral fissures, high-arched palate, low-set ears, and short neck with mild pterygium colli. [bio2rdf.org]
All 3 had dolichocephaly, aprominent nasal root, oblique palpebral fissures, a higharched palate, low-set ears, and a short neck with mild Table 3. [docslide.net]
Workup
Secondary: Postradiation neck extensor myopathy, Anterior scar contracture, Postbotulinum toxin injection, Cushing syndrome, Carnitine deficiency, Hypothyroidism, Hypokalemia, Hyperparathyroidism Other : Malignancy, Postsurgical Diagnostic Workup of Dropped [sites.google.com]
Treatment
Treatment Treatment Options: No treatment for the general disorder has been reported. [disorders.eyes.arizona.edu]
Is there a treatment? Currently there is no treatment for minicore myopathy although management of the condition is very important. [musculardystrophyuk.org]
[ edit ] The treatment of arthrogryposis includes occupational therapy, physical therapy, splinting and surgery. [3] The primary long-term goals of these treatments are increasing joint mobility, muscle strength and the development of adaptive use patterns [en.wikipedia.org]
Individuals/Families Peer Support Peer-to-peer Counseling Referrals to Local Chapter or Group Patient Navigators Translation Services Therapy & Counseling Professional Counseling Crisis Intervention Grief Counseling Medical Referrals Medical Care Clinical or Treatment [diseaseinfosearch.org]
Treatment - Minicore myopathy- antenatal onset- with arthrogryposis Not supplied. Resources - Minicore myopathy- antenatal onset- with arthrogryposis Not supplied. [checkorphan.org]
Prognosis
Ovulation Tests o Home Fertility Tests o Home Rhesus/RH Blood Type Tests o Home Fetal Tests * Fertility-related Home Testing: o Home Ovulation Tests o Home Fertility Tests * Male Fertility Tests o Home Sperm Tests o Sperm Count Tests o Sperm Motility Tests Prognosis [checkorphan.org]
Prognosis: variable course Diagnosis : Histopathology: • More type 1 fibres than type 2. • Within these fibres, there are structures which are called ‘cores’; which can be seen under the microscope. [slideshare.net]
SMA) Autosomal recessive inherited disease: Second most common group of fatal recessive diseases Abnormality of the large anterior horn cells Diagnosed via EMG, biopsy, genetic testing: Commonly demonstrate tongue fasciculations No cure with variable prognosis [quizlet.com]
Prognosis [ edit ] People with AMC look their worst at birth. AMC is considered non-progressive, so with proper medical treatment, things can improve. The joint contractures that are present will not get worse than they are at the time of birth. [en.wikipedia.org]
Prognosis Respiratory impairment is the main prognostic factor in SEPN1-related MmD and has to be managed pro-actively; patients can usually be maintained on nocturnal non-invasive ventilation for many years without major functional deterioration. [ncbi.nlm.nih.gov]
Etiology
Onset after 18 months, Chronic/Juvenile form Variant of SMA – Fazio Londe disease – Progressive bulbar palsy Etiology : Pathologic continuation of a process of programmed cell death (Apoptosis), which is normal in embryologic life. [dnbpediatrics.com]
[…] infection Arthrogryposis, SMA, CMT2/HSMN, ALS (rate of progression: slow to fast) Arthrogryposis Multiplex Congenita (AMC) Neurogenic and myopathic disorders Fetal joints are immobilized due to muscle weakness Anterior horn cell degeneration Unknown etiology [quizlet.com]
Arthrogryposis (multiple congenital contractures): Diagnostic approach to etiology, classification, genetics, and general principles. European Journal of Medical Genetics, 57(8), 464-472. doi:10.1016/j.ejmg.2014.03.008 Solicitar información [igenomix.es]
Accumulation of other proteins also occurs, including the actin cross-linking protein γ-filamin, αβ-crystallin, small heat shock protein 27, and myotilin 46 ; however, these are nonspecific findings and may be observed in core formation of different etiology [clinicalgate.com]
Multiple congenital contractures: birth prevalence, etiology, and outcome. J. Pediatr. 2002;140:61–67. doi:10.1067/mpd.2002.121148. [PubMed] [Google Scholar] 38. [ncbi.nlm.nih.gov]
Epidemiology
"Arthrogryposis multiplexa congenita: An epidemiologic study of nearly 9 million births in 24 EUROCAT registers". European Journal of Obstetrics & Gynecology and Reproductive Biology. 159 (2): 347–50. doi : 10.1016/j.ejogrb.2011.09.027. [en.wikipedia.org]
Epidemiology: Worldwide: Incidence:6 per 100,000 live births or 1/10th of all neuromuscular disorders. [slideshare.net]
Epidemiology Epidemiological data are only available for the congenital myopathies as a group but not for individual conditions. [ncbi.nlm.nih.gov]
This chapter summarizes the epidemiology, clinical features, investigations, and management of the congenital myopathies as a group and outlines specific features, genetics, and pathogenesis of the major disease entities in more detail. [clinicalgate.com]
Pathophysiology
However, relatively few TTN mutations and phenotypes are known, and titin pathophysiological role in cardiac and skeletal muscle conditions is incompletely understood. [kclpure.kcl.ac.uk]
For detailed information about rare diseases (pathophysiology, treatment options), treatment centres, and patient organisations, visit Orphanet (www.orpha.net) to find information about more than 5.000 rare diseases. [orphananesthesia.eu]
CAS Article Google Scholar 31 Arbogast S, Beuvin M, Fraysse B, Zhou H, Muntoni F, Ferreiro A : Oxidative stress in SEPN1-related myopathy: from pathophysiology to treatment. Ann Neurol 2009; 65: 677–686. [nature.com]
[…] and MHS have been extensively investigated in response to the in vitro contracture test (IVCT), in cultured myotubes from patients and in various homologous and heterologous expression systems, resulting in a tentative understanding of the molecular pathophysiology [ncbi.nlm.nih.gov]
Prevention
Equipment to prevent trunk deformities Developmental activities Understand the pathogenicity of the disease Evaluate functional abilities Design treatment to maximize function and reduce secondary effects Avoid fatigue/overuse syndromes SMA Type 2: [quizlet.com]
VERTICAL SUSPENSION: o Examiner places both hands in axilla and with out grasping thorax, lifts straight up. o With weakness, infant needs to be grasped around trunk to prevent falling. [dnbpediatrics.com]
Minicore myopathy- antenatal onset- with arthrogryposis Other Possible Causes of these Symptoms * Delayed motor development * High arched palate * Long head * Low set ears * Muscle wasting * Muscle weakness * Respiratory problems * Short neck * Short neck Prevention [checkorphan.org]
A feeding tube prevents this from happening. There are a number of different types of feeding tube which are available, and these are fitted by a short surgical procedure. [musculardystrophyuk.org]
A disruption in calcium ion transport prevents muscles from contracting normally, leading to the muscle weakness characteristic of multiminicore disease. RYR1 gene mutations are also associated with an increased risk of malignant hyperthermia. [encyclopedia.pub]