Presentation
Neuromuscular syndromes are presented clinically either as a case study or as an overview from the literature, accompanied by text presenting molecular defects, and differential diagnosis. [books.google.de]
Clinical Presentation Hepatic Presentation Hepatomegaly, short stature, hypoglycemia, and hyperlipidemia predominate in children, may be indistinguishable from GSD I. Splenomegaly can be present. kidneys are not enlarged and renal function is [slideshare.net]
The clinical presentation is that of progressive/relapsing and remitting muscle weakness present for more than 2 months, symmetrical proximal and distal extremity weakness and hyporeflexia. [neuroweb.us]
Additionally, even though most myopathies present with proximal shoulder and girdle weaknesses, some forms may present with distal weakness and, thereby, mimic neuropathies. [mayomedicallaboratories.com]
Age In its classic form, glycogen-storage disease type IV presents during the first year of life with hepatosplenomegaly and failure to thrive. Patients with nonprogressive liver disease may present later in childhood. [emedicine.medscape.com]
Entire Body System
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Physician
Genetic Neuromuscular Disorders: A Case-Based Approach is aimed at neuromuscular physicians and neurology residents. [books.google.de]
In the past, GSDs were also named by the discovering physician, as indicated in Table 1. [knowledge.statpearls.com]
Author Lynne Ierardi-Curto, MD, PhD Attending Physician, Division of Metabolism, Children's Hospital of Philadelphia Disclosure: Nothing to disclose. [emedicine.medscape.com]
However, in cases where clinically relevant information is identified, the ordering physician will be informed of the result and provided with recommendations for any appropriate follow-up testing. [mayomedicallaboratories.com]
The ancient Indtan physicians were aware of diseases with proximal muscle weakness in spite of muscle enlargement, the finding that is commonly seen in various metabolic myopcithies and muscular dystrophies. [annalsofneurosciences.org]
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Pathologist
Confidently prepare for the upcoming recertification exams for clinical pathologists set to begin in 2016. [books.google.com]
Psychiatrical
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Suggestibility
Key points for each genetic disease are identified to suggest treatment, when available, or the main clinical exams useful in follow-up of patients. [books.google.de]
or pipestem capillaries that would suggest dermatomyositis (DM) or another type of humorally mediated microangiopathy. [sites.google.com]
Recent work on myoclonus epilepsy with Lafora bodies ( Lafora disease) suggests that this is a glycogenosis, probably due to abnormal glycogen synthesis. GSD II can be treated by enzyme replacement therapy, but there is no specific treatment for [slideshare.net]
LUBAC has a MW of approximately 600 kDa suggesting a heteromultimeric assembly of its subunits. Interacts with beta-I-type (PRKCB1) and zeta-type protein kinase C (PRKCZ) and with UBE2L3. Interacts with PRKCH. [uniprot.org]
Blueprint Genetics’ Plus Analysis (Seq Del/Dup) maximizes the chance to find a molecular genetic diagnosis for your patient although Sequence Analysis or Del/Dup Analysis may be a cost-effective first line test if your patient’s phenotype is suggestive [blueprintgenetics.com]
Neurologic
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Limb Weakness
Once exome sequencing becomes routine – say 5 years from now – a health care professional evaluating an adult with distal limb weakness, profound fatigue, and urinary urgency can pop a blood sample into a device that will quickly detect, or rule out, [blogs.plos.org]
weakness such as foot drop can be through the use of Ankle Foot Orthoses (AFOs) which can be designed or selected by an Orthotist based upon clinical need of the individual. [en.wikipedia.org]
Limb weakness is usually affecting proximal, muscles more than distal musculature. Both upper and lower extremities are involved, although the legs are usually affected more severely. Deep tendon reflexes are absent or depressed. [neuroweb.us]
Proximal limb weakness is common to all patients and is often progressive; facial and respiratory muscle weakness may occur. Muscle cramps and exercise intolerance have been described but are not particularly major features of this disorder. [annalsofneurosciences.org]
The most common cause of premature death in oculopharyngeal muscular dystrophy (OPMD) is complications related to lack of treatment of dysphagia Mild neck and proximal limb weakness is seen. No myotonia. No abnormal reflexes. [sites.google.com]
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
Key points for each genetic disease are identified to suggest treatment, when available, or the main clinical exams useful in follow-up of patients. [books.google.de]
Effectively monitor the pace of drug clearing in patients undergoing pharmacogenomic treatments with a new chapter on this groundbreaking new area. [books.google.com]
Dietary Treatment The goal of treatment is, as far as possible, to prevent hypoglycemia, thus limiting secondary metabolic derangements. Initially, treatment consisted of frequent carbohydrate- enriched meals during day and night. In 1974, continuous [slideshare.net]
Read more Corticosteroid treatment of DMD: summary of practice guideline for clinicians This paper provides a summary of the 2005 American Academy of Neurology (AAN) guideline update, “Corticosteroid treatment of Duchenne muscular dystrophy.” [institut-myologie.org]
Prognosis
Follow-up, Complications, Prognosis, Proximal and distal renal tubular as well as glomerular functions are at risk. Single or multiple liver adenomas may develop in the second or third decade. Osteopenia. Anemia. Polycystic ovaries (PCOs). [slideshare.net]
Prognosis [ edit ] A 2009 review noted that muscle weakness usually begins after age 20 and after 20–30 years, the person usually requires a wheel chair for mobility. [en.wikipedia.org]
The course of AMSAN is typically fulminant and the prognosis is generally poor. Median time to regain ability to walk 5 meters with assistance is 1 month. Iv immunoglobulin are less effective than in GBS. [neuroweb.us]
Treatment and Prognosis: Fewer than 20% of patients survive beyond 3 years. Response to corticosteroids is variable, but some do respond. Most require a 2nd line cytotoxic agent. BMT for refractory cases. [sites.google.com]
Etiology
Etiology The etiology of GSD is best understood by following the metabolic events leading to the synthesis (glycogenesis) and degradation of glycogen (glycogenolysis). [knowledge.statpearls.com]
Carrillo N, Malicdan MC, Huizing M (2018) GNE myopathy: Etiology, diagnosis, and therapeutic challenges. Neurotherapeutics doi: 10.1007/s13311-018-0671-y "Inclusion body myopathy 3". NIH Genetic and Rare Diseases Information Center. [en.wikipedia.org]
Pathogenesis: Unknown etiology. Eosinophilia may be the result of effect of T-cell clones. Oligoclonal expansion of T cells within the muscle in PM is noted. [sites.google.com]
Epidemiology
[…] related nemaline myopathy and response to acetylcholinesterase inhibitors Identification of a novel form of recessive SCN4A-related congenital myopathy Other neuromuscular diseases and basic research Prevalence of HSMNR in the Czech Republic Reviewing the epidemiology [institut-myologie.org]
Epidemiology The overall incidence of GSD (all forms) in Europe, Canada, and the United States is estimated to be between 1 in 20,000 and 1 in 40,000. [knowledge.statpearls.com]
Epidemiology Frequency International Glycogen-storage disease type IV represents an uncommon form of glycogen-storage disease. [emedicine.medscape.com]
Chinnery PF, Johnson MA, Wardell TM et al. (2000) The epidemiology of pathogenic mitochondrial DNA mutations. Ann Neurol 48: 188–193 PubMed Google Scholar 18. [link.springer.com]
It appears that the general spectrum of myopathies described in the world literature is also seen in India, although the prevalence is difficult to ascertain, as there is very little published epidemiological data. [annalsofneurosciences.org]
Pathophysiology
Pathophysiology Figure 1 summarizes the pathophysiology for each GSD, along with organ(s) affected, as well as the potential signs. In general, GSDs primarily affect the liver, skeletal muscle, or both. [knowledge.statpearls.com]
The pathophysiology is still unclear. Cardiac involvement may occur. [en.wikipedia.org]
Pathophysiology Deficient glycogen-branching enzyme activity results in the formation of abnormal glycogen with long, unbranched outer chains and decreased solubility. [emedicine.medscape.com]
The following algorithms are available in Special Instructions: -Inherited Motor Neuron Disease Testing Algorithm -Neuromuscular Myopathy Testing Algorithm Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they [mayomedicallaboratories.com]
MELAS and L-arginine therapy: pathophysiology of stroke-like episodes Ann N Y Acad Sci 2010; 1201: 104-. [69] Iizuka T, Sakai F, Endo M, Suzuki N. Response to sumatriptan in headache of MELAS syndrome Neurology 2003; 61: 577-8. [70] Santa KM. [benthamopen.com]
Prevention
Knowledge of the pathogenesis, genetics, and molecular biology of neuromuscular disorders is essential both in developing and applying new therapies and preventive measures, and in formulating genetic and prognostic advice. [books.google.com]
In skeletal muscle, e.g., GSD 5, this can prevent proper muscle functioning, exercise intolerance and rhabdomyolysis. [knowledge.statpearls.com]
Prevention of secondary complications: Gait aids to prevent falls and urologic management to prevent urosepsis. Surveillance: Periodic assessment of bladder function, gait, sensation in the distal lower extremities, and cognition. [ncbi.nlm.nih.gov]
[…] to reduce or prevent further deterioration of renal function. [slideshare.net]