Edit concept Question Editor Create issue ticket

Hereditary Motor and Sensory Neuropathy

HMSN


Presentation

  • Individuals with CMT 3 (Dejerine-Sottas disease) have a primarily demyelinating peripheral neuropathy with a more severe phenotype presenting in infancy.[academlib.com]
  • At present, mutations in ten different genes have been identified, chromosomal localisation of many other distinct inherited neuropathies has been mapped, and new genetic causes for inherited neuropathies continue to be discovered.[ncbi.nlm.nih.gov]
  • HNPP Symptoms (Not all symptoms and signs may be present.)[foundationforpn.org]
  • Romberg may be positive, but pure cerebellar (nystagmus, dysmetria) or upper motor neuron signs should not be present.[now.aapmr.org]
  • Presentation [ 5 ] Onset is insidious and slowly progressive. CMT1 This is the most common form.[patient.info]
Difficulty Walking
  • walking Difficulty in walking 0002355 Distal amyotrophy Distal muscle wasting 0003693 Distal sensory impairment Decreased sensation in extremities 0002936 Dysphonia Inability to produce voice sounds 0001618 Foot dorsiflexor weakness Foot drop 0009027[rarediseases.info.nih.gov]
  • Patients may experience difficulty walking or running, often tripping. Pressure palsies are common. Spinal deformities (eg, thoracic scoliosis) occur in 37-50% of patients with CMT1.[patient.info]
  • You may also experience loss of sensation and muscle contractions, and difficulty walking. Foot deformities such as hammertoes and high arches also are common.[mayoclinic.org]
  • Muscle weakness can cause weak ankles and eventually progress to difficulty walking (gait disturbances). Some older affected individuals (e.g. those in their 60s or 70s) may eventually require a wheelchair.[rarediseases.org]
Aspiration
Acrocyanosis
  • Other common symptoms and signs include hand tremors, muscle cramps and acrocyanosis. It may be possible to palpate enlarged and excessively firm nerves.[patient.info]
Muscular Atrophy
  • Charcot-Marie-Tooth disease Déjérine-Sottas disease Hereditary motor and sensory neuropathy, types I-IV Hypertrophic neuropathy of infancy Peroneal muscular atrophy (axonal type) (hypertrophic type) Roussy-Levy syndrome MS-DRG Mapping DRG Group #073-074[icd.codes]
  • atrophy (axonal type) (hypertrophic type) Roussy-Levy syndrome Information for Patients Charcot-Marie-Tooth Disease Also called: Hereditary motor and sensory neuropathy, Peroneal muscular atrophy Charcot-Marie-Tooth disease (CMT) is a group of genetic[icdlist.com]
  • Hereditary and idiopathic neuropathy G60.0 Hereditary motor and sensory neuropathy Inclusion term(s): Charcot-Marie-Tooth disease Déjérine-Sottas disease Hereditary motor and sensory neuropathy, types I-IV Hypertrophic neuropathy of infancy Peroneal muscular[icd10coded.com]
  • Applicable To Charcot-Marie-Tooth disease Déjérine-Sottas disease Hereditary motor and sensory neuropathy, types I-IV Hypertrophic neuropathy of infancy Peroneal muscular atrophy (axonal type) (hypertrophic type) Roussy-Levy syndrome The following code[icd10data.com]
  • Abstract Central motor conduction to the small hand muscles was investigated in 59 patients with peroneal muscular atrophy and hereditary spastic paraplegia (HSP) by using transcranial magnetic brain stimulation.[ncbi.nlm.nih.gov]
Progressive Muscle Wasting
  • The ICD code G600 is used to code Roussy-Lévy syndrome Roussy-Lévy syndrome, also known as Roussy-Lévy hereditary areflexic dystasia, is a rare genetic disorder of humans that results in progressive muscle wasting. it is caused by mutations in the genes[icd.codes]
Fear
  • Many patients and families are ashamed and fearful about diagnosis, and benefit from meeting others with CMT in person or online.[now.aapmr.org]
Onset in Infancy or Childhood
  • […] in infancy or childhood and is characterized by extremely slow nerve conduction velocities resulting in loss of ambulatory milestones and more generalized neurologic deficit; 4) HMSN 4, an autosomal recessive inherited demyelinating form that may also[mayomedicallaboratories.com]
Irregular Menstruation
  • In females it is helpful in general weakness, lower back pain, ovarian cysts, painful and irregular menstruation and lack of glow on face. 4. Yograj Guggul : Yograj Guggul is a very famous Ayurvedic medicine in tablet form.[alwaysayurveda.net]
Cerebellar Ataxia
  • ataxia, deafness, and narcolepsy AD 9 19 DST Neuropathy, hereditary sensory and autonomic AR 9 7 DYNC1H1 Spinal muscular atrophy, Charcot-Marie-Tooth disease, Mental retardation AD 57 64 EGR2 Neuropathy, Dejerine-Sottas disease, Charcot-Marie-Tooth disease[blueprintgenetics.com]
Hand Tremor
  • Other common symptoms and signs include hand tremors, muscle cramps and acrocyanosis. It may be possible to palpate enlarged and excessively firm nerves.[patient.info]
Posture Abnormal
  • Night splinting does not appear helpful to increase the range of ankle movements. [ 7 ] Pharmacological Pain is common and is related to skeletal deformities, postural abnormalities, muscle fatigue and nerve damage.[patient.info]
Dysmetria
  • Romberg may be positive, but pure cerebellar (nystagmus, dysmetria) or upper motor neuron signs should not be present.[now.aapmr.org]

Workup

  • Nerve conduction studies may be more expeditiously carried out on an affected FIGURE 18.13 Progressive cavus foot deformities with clawing of the toes on CMT. parent to guide the molecular genetic workup of an affected child.[academlib.com]
  • Clinical Testing and Workup Nerve conduction studies (NCS) and electromyography (EMG) are very useful.[rarediseases.org]

Treatment

  • Since muscle wasting and sensory disturbance are the main features of these syndromes, treatments aim to improve motor impairment and sensory disturbances. Specific treatment trials are rare.[cochrane.org]
  • TREATMENT: There is no known pharmacological treatment to hereditary motor and sensory neuropathies. However, people with these diseases can walk and be self-sufficient.[alwaysayurveda.net]
  • & Therapy (Not all treatments and therapies may be indicated.)[foundationforpn.org]
  • Currently, no definitive treatment exists for HMSN. It cannot be stopped or reversed, but it can reach a point where the progression steadies itself.[aanem.org]
  • TO TOP What treatments are available? Currently, there is no known cure for HMSN/ACC or treatments to prevent the onset of symptoms.[muscle.ca]

Prognosis

  • It is only by knowing the natural history that one understands the onset of clinical symptoms, the rate of progression, and the ultimate prognosis of these diseases.[clinicaltrials.gov]
  • Prognosis [ edit ] Hereditary motor and sensory neuropathy are relatively common and are often inherited with other neuromuscular conditions, and these comorbidities cause an accelerated progression of the disease.[en.wikipedia.org]
  • CMT in pregnancy increases the risk for complications during delivery and a higher risk of intervention. [ 11 ] Prognosis This is dependent on subtype; clinical impairment and disability correlate with axonal loss: Most patients with CMT1A have normal[patient.info]
  • Treatment and prognosis Unfortunately no effective drug for CMT exists. Treatment is largely supportive with rehabilitation therapy and surgery for skeletal deformities 5.[radiopaedia.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Abstract Hereditary motor and sensory neuropathies (HMSN) is a complex group of diseases, mainly of unknown etiology.[ncbi.nlm.nih.gov]
  • Diagnostic tests, usually beginning electrodiagnostic testing, are indicated in patients with atypical clinical features, unknown etiology, and/or severe or rapidly progressive symptoms.[amboss.com]
  • Several demyelinating etiologies can produce a “Dejerine-Sottas” phenotype with early onset, palpable nerves, and marked onion-bulb formation.[now.aapmr.org]
  • (Etiology) The cause of Hereditary Sensory Neuropathy Type II is a recessive mutation in either the WNK1 gene on chromosome 12 (A), the FAM134B gene on chromosome 5 (B), the KIF1A gene on chromosome 2 (C), or in the SCN9A gene on chromosome 2 (D).[dovemed.com]

Epidemiology

  • Abstract A clinical, genetic and epidemiological study of hereditary motor and sensory neuropathies (HMSN) was performed in the province of Turin, Italy. The patients were allocated to 5 groups, according to genetic and electroneurographic features.[ncbi.nlm.nih.gov]
  • Epidemiology It is the most common inherited neuromuscular disorder affecting 1 in 2,500 people. [ 1 ] It has no predilection for a particular race or sex.[patient.info]
  • Epidemiology including risk factors and primary prevention HMSN is the most common inherited neuromuscular disease with overall prevalence of approximately 1/2500 and incidence 15/100,000 in the general population.[now.aapmr.org]
  • Epidemiologic Study of Charcot-Marie-Tooth Disease: A Systematic Review. Neuroepidemiology. 2016. 46 (3):157-65. [Medline]. Garcia CA, Malamut RE, England JD, Parry GS, Liu P, Lupski JR.[emedicine.medscape.com]
  • Int. (1995) [ Pubmed ] Charcot-Marie-Tooth disease in northern Sweden: an epidemiological and clinical study. Holmberg, B.H. Acta neurologica Scandinavica. (1993) [ Pubmed ][wikigenes.org]
Sex distribution
Age distribution

Pathophysiology

  • In HMSN II with accompanying pyramidal features, 6 of the 10 patients had abnormal central motor conduction, although conduction times were only slightly prolonged, suggesting a different pathophysiological pattern.[ncbi.nlm.nih.gov]
  • See Hereditary Peripheral Neuropathies Testing Algorithm in Special Instructions Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Inherited peripheral neuropathies are a diverse[mayomedicallaboratories.com]
  • The molecular dissection of cellular functions of the related gene products has only just begun, and detailed pathophysiological models are still lacking.[nature.com]
  • Pathophysiology CMT1A The extra PMP22 gene copy within the 1.5 mB duplication on chromosome 17 is believed to cause most cases. [12] PMP22 is a 160 amino acid integral membrane protein that is expressed at high levels in myelinating Schwann cells, localizing[emedicine.medscape.com]

Prevention

  • Since foot disorders are common with neuropathy, precautions must be taken to strengthen these muscles and use preventative care and physical therapy to prevent injury and deformities.[en.wikipedia.org]
  • Leg braces prevent ankle sprains and improve walking ability. Surgery: For some people, surgery can help prevent or reverse foot and joint deformities. Pain management: Pain-killing drugs may be prescribed for people who have severe pain.[hnf-cure.org]
  • Lightweight lower leg braces, special shoes or shoe inserts can help prevent ankle sprains and maximize independence. Surgery may be suggested to correct foot deformities.[foundationforpn.org]
  • Primary prevention is genetic counseling.[now.aapmr.org]
  • This prompt diagnosis is useful for providing a well-timed treatment, establishing a recurrence risk and preventing further investigations poorly tolerated by patients and expensive for the health system.[ncbi.nlm.nih.gov]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!