Presentation
Clearly presented in a tried and trusted, easy-to-use, format, each book in the series gives complete coverage of the subject in a no-nonsense, user-friendly fashion. [books.google.com]
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]
Acronym MPXPS Any medical or genetic information present in this entry is provided for research, educational and informational purposes only. [uniprot.org]
Particular clinical presentations of neurometabolic disorders include ataxias, movement disorders, childhood epilepsies, or peripheral neuropathy. [oxfordmedicine.com]
Entire Body System
- Weakness
[…] characterized by early-onset proximal muscle weakness with a static course and moderately to grossly elevated serum creatine kinase levels accompanied by learning difficulties. [malacards.org]
The muscle weakness does not progress, but most patients develop progressive atypical involuntary muscle contractions that influence gait, movement, and posture (extrapyramidal signs) that may be disabling. [rarediseases.org]
[…] insufficiency out of proportion to limb weakness; and 3) respiratory muscles weakness without any other severe muscle involvement. [neuroweb.us]
In the history, it is important to determine exactly what the patient means by "weak"; what are the specific muscle groups that are weak; whether there are associated findings with the weakness; and what has been the timing of onset of the weakness. [dartmouth.edu]
- Disability
NIH Rare Diseases : 53 Myopathy with extrapyramidal signs is a disorder characterized by early childhood onset of proximal muscle weakness (muscles closest to the body’s midline) and learning disabilities. [malacards.org]
The muscle weakness does not progress, but most patients develop progressive atypical involuntary muscle contractions that influence gait, movement, and posture (extrapyramidal signs) that may be disabling. [rarediseases.org]
While the muscle weakness is static, most patients develop progressive extrapyramidal signs, including chorea, tremor, dystonic posturing and orofacial dyskinesia, that may become disabling (summary by Logan et al., 2014; pubmed:24336167). [flybase.org]
- Movement Disorder
[…] by proximal myopathy, learning difficulties, and a progressive extrapyramidal movement disorder. [malacards.org]
Particular clinical presentations of neurometabolic disorders include ataxias, movement disorders, childhood epilepsies, or peripheral neuropathy. [oxfordmedicine.com]
Signs and symptoms are variable and include brief, repetitive, jerky and uncontrolled movements caused by muscle contractions (chorea), tremor, abnormal posturing, and involuntary repetitive movements of the mouth and face.[1] Other symptoms may include [rarediseases.info.nih.gov]
- Developmental Delay
Affiliated tissues include eye, skeletal muscle and liver, and related phenotypes are chorea and global developmental delay Disease Ontology : 12 A myopathy characterized by early childhood onset of proximal muscle weakness, with development of progressive [malacards.org]
[…] ganglia MRI signal intensity 0012751 Central core regions in muscle fibers 0030230 Centrally nucleated skeletal muscle fibers 0003687 Chorea 0002072 Difficulty running 0009046 Difficulty walking Difficulty in walking 0002355 Dystonia 0001332 Global developmental [rarediseases.info.nih.gov]
- Difficulty Walking
[…] running 0009046 Difficulty walking Difficulty in walking 0002355 Dystonia 0001332 Global developmental delay 0001263 Increased variability in muscle fiber diameter 0003557 Orofacial dyskinesia 0002310 Progressive extrapyramidal movement disorder 0007153 [rarediseases.info.nih.gov]
Gastrointestinal
- Vomiting
The patient should be induced to vomit even if emesis has occurred spontaneously. Pharmacologic vomiting by the administration of ipecac syrup is a preferred method. [mentalhealth.com]
Many agents used to control nausea and vomiting in other settings are nearly useless for the very severe nausea and vomiting that accompanies chemotherapy. [usmle.net]
The Faculty of the 2nd International Scientific Symposium on Cyclic Vomiting Syndrome. Dig Dis Sci. 1999 ; 44(8 suppl) : 9S – 11S ↵ Stickler GB. Relationship between cyclic vomiting syndrome and migraine. [pediatrics.aappublications.org]
[…] essentially means imbalance Vermal versus cerebellar lesions vermal: produce truncal and gait ataxia while hemispheric produces ipsilateral limb ataxia Cerebellar hemorrhage or infarction abrupt onset of vertigo, vomiting, inability to walk Potential; [quizlet.com]
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More Common Constipation headache loss of appetite nausea vomiting Less Common Bitter or metallic taste decrease [drugs.com]
- Diarrhea
[…] skin blurred or double vision chest pain chills clay-colored stools confusion confusion as to time, place, or person coughing or spitting up blood cracks in the skin dark urine decreased awareness or responsiveness decreased urine output depression diarrhea [drugs.com]
Bismuth (choice A) preparations can be used to control diarrhea and mild nausea of the vertigo/motion sickness type, but are nearly useless with chemotherapy-induced vomiting. [usmle.net]
The functional gastrointestinal disorders of childhood are classified according to the ROME II criteria in 4 groups and several subgroups. 104 The groups include (1) vomiting, (2) abdominal pain, (3) functional diarrhea, and (4) disorders of defecation [pediatrics.aappublications.org]
Autonomic: Dry mouth or salivation, nausea, vomiting, gastric retention, diarrhea, anorexia, constipation, obstipation, fecal impaction, urinary retention, frequency or incontinence, bladder paralysis, polyuria, nasal congestion, pallor, miosis, mydriasis [mentalhealth.com]
The symptoms appear 3 to 5 days after the tick attaches itself to the skin and are often preceded by malaise, irritability, and diarrhea. [intranet.tdmu.edu.ua]
- Nausea
Many agents used to control nausea and vomiting in other settings are nearly useless for the very severe nausea and vomiting that accompanies chemotherapy. [usmle.net]
Other side effects include: persistent ventricular tachycardia, pneumonitis, bradycardia, abnormal hepatic function tests, nausea, abnormal gait, asthenia, constipation, cough, dizziness, dyspnea, fatigue, heart block, involuntary body movements, neurotoxicity [drugs.com]
Severe Nausea and Vomiting in Adults: 8 to 16 mg daily in divided doses; 24 mg occasionally may be necessary; early dosage reduction is desirable. [mentalhealth.com]
Protracted episodes of nausea and vomiting can be triggered by emotional or physical stress or even arousal from sleep. [pediatrics.aappublications.org]
Fatigue is also a major feature of many with mitochondrial disorders where it is often associated with malaise, headache or nausea and sometimes vomiting, reflecting an exercise induced lactic acidosis. [jnnp.bmj.com]
- Muscle Rigidity
Phencyclidine intoxication (choice E) causes behavioral changes shortly after the use of drug, as well as two or more of the following signs: ataxia, nystagmus, hypertension, tachycardia, dysarthria, muscle rigidity, numbness, seizures, or coma. [usmle.net]
Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmias). [mentalhealth.com]
Eyes
- Prolapse
This is associated with conditions such as peroneal nerve injury, fibular injury, multiple sclerosis, Guillain-Barré syndrome, and prolapsed intervertebral disc. [patient.info]
Prolapsed mitral valve and atrial flutter 54 sometimes occur in the early stages of the disease. More advanced cases with severe cardiac fibrosis suffer cardiac arrhythmias. Syncopal attacks may occur. [intranet.tdmu.edu.ua]
Musculoskeletal
- Myopathy
Name myopathy with extrapyramidal signs FlyBase ID FBhh0000844 This report describes myopathy with extrapyramidal signs (MPXPS); MPXPS exhibits autosomal recessive inheritance. [flybase.org]
More Symptoms of Myopathy with extrapyramidal signs » Treatments See also the following treatment articles: Treatments for Myopathy Causes See also causal information: Causes of Myopathy Similar Topic Articles Myopathy Extrapyramidal signs Names and Terminology [familydiagnosis.com]
MalaCards based summary : Myopathy with Extrapyramidal Signs, also known as proximal myopathy with extrapyramidal signs, is related to myopathy and muscular dystrophy, limb-girdle, autosomal recessive 1, and has symptoms including tremor and involuntary [malacards.org]
Synonyms Proximal myopathy with extrapyramidal signs Overview Myopathy with extrapyramidal signs is a disorder characterized by early childhood onset of proximal muscle weakness (muscles closest to the body’s midline) and learning disabilities. [rarediseases.org]
- Muscle Weakness
NIH Rare Diseases : 53 Myopathy with extrapyramidal signs is a disorder characterized by early childhood onset of proximal muscle weakness (muscles closest to the body’s midline) and learning disabilities. [malacards.org]
The muscle weakness does not progress, but most patients develop progressive atypical involuntary muscle contractions that influence gait, movement, and posture (extrapyramidal signs) that may be disabling. [rarediseases.org]
weakness and learning disabilities. [flybase.org]
[…] disorder 0007153 Progressive extrapyramidal muscular rigidity 0007158 Proximal muscle weakness Weakness in muscles of upper arms and upper legs 0003701 Resting tremor Tremor at rest 0002322 5%-29% of people have these symptoms Ataxia 0001251 Microcephaly [rarediseases.info.nih.gov]
- Proximal Muscle Weakness
GARD : 20 Myopathy with extrapyramidal signs is a disorder characterized by early childhood onset of proximal muscle weakness (muscles closest to the body's midline) and learning disabilities. [malacards.org]
Definition An autosomal recessive disorder characterized by early-onset proximal muscle weakness with a static course and moderately to grossly elevated serum creatine kinase levels accompanied by learning difficulties. [uniprot.org]
Signs and Symptoms Proximal muscle weakness ... ... [familydiagnosis.com]
- Small Head
head (microcephaly), drooping of the eyelids, wasting of the eye nerve (optic atrophy), and axonal peripheral neuropathy. [rarediseases.org]
[…] skull Decreased circumference of cranium Decreased size of skull Reduced head circumference Small head circumference [ more ] 0000252 Mildly elevated creatine kinase 0008180 Ophthalmoplegia Eye muscle paralysis 0000602 Optic atrophy 0000648 Peripheral [rarediseases.info.nih.gov]
- Muscle Spasm
[…] weakness Frequency not reported : Back pain Postmarketing reports : Myopathy, rhabdomyolysis, muscle spasm, lupus -like syndrome [ Ref ] Local Common (1% to 10%): Injection site reactions [ Ref ] Genitourinary Very rare (less than 0.01%): Epididymo-orchitis [drugs.com]
Neurologic
- Ataxia
olivopontocerebellar atrophy Associated symptoms of cerebellar ataxia and differential-hyporeflexia or aryflexia Miller Fisher syndrome, Friedreich ataxia, alcoholic cerebellar degeneration, hypothyroidism Associated symptoms of cerebellar ataxia and [quizlet.com]
[…] and/or extrapyramidal feature ADCA 3 – pure primarily cerebellar hemispheric disease ADCA 4 – ataxia with myoclonus and deafness ADCA5 – ataxia with essential tremor AD Cerebellar Ataxias SCA 1–25 Autosomal Recessive Ataxias Friedreich's ataxia Variant [neurodiffdx.com]
Additional variable features include ataxia, microcephaly, ophthalmoplegia, ptosis, optic atrophy and axonal peripheral neuropathy. [malacards.org]
Increasingly, however, late-onset phenotypes are being recognized (myopathy, ataxia, PEO). [neupsykey.com]
- Peripheral Neuropathy
Additional variable features include ataxia, microcephaly, ophthalmoplegia, ptosis, optic atrophy and axonal peripheral neuropathy. [malacards.org]
August 01, 1974 ; 24 (8) Article Rare case of myasthenia associated with peripheral neuropathy and spastic paraparesis JOHN C.M. BRUST, THEODORE A. LIST, LOUIS W. [neurology.org]
- Tremor
MalaCards based summary : Myopathy with Extrapyramidal Signs, is also known as proximal myopathy with extrapyramidal signs, and has symptoms including tremor and involuntary movements. [malacards.org]
Signs and symptoms are variable and include brief, repetitive, jerky and uncontrolled movements caused by muscle contractions (chorea), tremor, abnormal posturing, and involuntary repetitive movements of the mouth and face.[1] Other symptoms may include [rarediseases.info.nih.gov]
- Dystonia
[…] definition Proximal myopathy with extrapyramidal signs is a rare, hereditary non-dystrophic myopathy characterized by proximal muscle weakness, delayed motor development, learning difficulties, and progressive extrapyramidal motor signs including chorea, dystonia [orpha.net]
[…] symptoms Abnormal basal ganglia MRI signal intensity 0012751 Central core regions in muscle fibers 0030230 Centrally nucleated skeletal muscle fibers 0003687 Chorea 0002072 Difficulty running 0009046 Difficulty walking Difficulty in walking 0002355 Dystonia [rarediseases.info.nih.gov]
- Chorea
Signs and symptoms are variable and include brief, repetitive, jerky and uncontrolled movements caused by muscle contractions ( chorea ), tremor, abnormal posturing, and involuntary repetitive movements of the mouth and face. [malacards.org]
Most patients develop subtle extrapyramidal motor signs that progress to a debilitating disorder of involuntary movement with variable features, including chorea, tremor, dystonic posturing and orofacial dyskinesia. [uniprot.org]
Signs and symptoms are variable and include brief, repetitive, jerky and uncontrolled movements caused by muscle contractions (chorea), tremor, abnormal posturing, and involuntary repetitive movements of the mouth and face.[11115] Other symptoms may include [rarediseases.org]
Workup
Workup - other ECG Malabsorption workup Karyotyping and family screening 26. Treatment of Hypocalcemia 27. [slideshare.net]
Aspartate aminotransferase levels Other studies may include the following: Electrocardiography Antinuclear antibody levels Genetic testing Electromyography Magnetic resonance imaging (to assess complications or rule out neurologic disease) Muscle biopsy See Workup [emedicine.medscape.com]
Serum
- Creatine Phosphokinase Increased
[…] kinase Elevated blood creatine phosphokinase Elevated circulating creatine phosphokinase Elevated creatine kinase Elevated serum CPK Elevated serum creatine phosphokinase High serum creatine kinase Increased CPK Increased creatine kinase Increased creatine [rarediseases.info.nih.gov]
Treatment
More Symptoms of Myopathy with extrapyramidal signs » Treatments See also the following treatment articles: Treatments for Myopathy Causes See also causal information: Causes of Myopathy Similar Topic Articles Myopathy Extrapyramidal signs Names and Terminology [familydiagnosis.com]
Acute and preventive pharmacologic treatment of cluster headache. Neurology 2010, 75 ( 5 ):463-73. CrossRef PubMed Google Scholar 24. [link.springer.com]
[…] for which specific treatments are available. [mentalhealth.com]
It is not in any way intended to be used as a substitute for professional medical advice, diagnosis, treatment or care. Our staff consists of biologists and biochemists that are not trained to give medical advice. [uniprot.org]
Prognosis
Prognosis of MELAS syndrome is poor. [pliem.co.za]
The prognosis is most favorable when the onset of symptoms occurs after the second decade of life. [intranet.tdmu.edu.ua]
A poor prognosis for patients has been suggested if there are infratentorial lesions early in the course of the illness (particularly the MCP). Acute disseminated encephalomyelitis frequently evolves into MS. [neurodiffdx.com]
This distinction is important for genetic counseling of family members and for the patient’s prognosis, in that HSP generally carries a more favorable prognosis. [2] Other components of the differential diagnosis of HSP are similar to those of PLS. [emedicine.medscape.com]
For patients with CIPA/HSAN type IV, the prognosis for independent function depends on the ability to manage secondary clinical problems, especially the orthopedic issues. [pediatrics.aappublications.org]
Etiology
These conditions have widely varying etiologies, including congenital or inherited, idiopathic, infectious, metabolic, inflammatory, endocrine, and drug-induced or toxic. [emedicine.medscape.com]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
Etiology and Pathology The etiology is unknown. [intranet.tdmu.edu.ua]
Muscle disease often results in an increase in creatine kinase levels in the blood, although this is quite nonspecific in terms of etiologic diagnosis. [dartmouth.edu]
Epidemiology
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
Vågå study of headache epidemiology. Cephalalgia 2003, 23 ( 7 ):528–533. CrossRef PubMed Google Scholar 5. Russell MB: Epidemiology and genetics of cluster headache. Lancet Neurol 2004, 3 ( 5 ):279–283. CrossRef PubMed Google Scholar 6. [link.springer.com]
At first considered a rare condition, it is now recognized as one of the most frequent dementing disorders, second in incidence only to Alzheimer disease in most hospital-based epidemiological studies. [usmle.net]
Epidemiologic data suggest that smoking may be an established risk factor for sporadic ALS. [8] The peak age of onset is between 55 and 75 years. [emedicine.medscape.com]
Epidemiology The prevalence of PD is 133 per 100 000 people. This disease is considered to be one of the most common ones among old people after dementia, epilepsy, cerebral vascular diseases. The beginning of the disease is at the age of 55. [intranet.tdmu.edu.ua]
Pathophysiology
The output is generated by the deep cerebellar nuclei and … [PDF][PDF] Disorders of the cerebellum and its connections CM Fredericks - Fredericks CM, Saladin LK. eds: Pathophysiology …, 1996 - deardegree.com The cerebellum, which lies just dorsal to the [scholar.google.it]
Pathophysiology Ionized calcium is affected by: Albumin Blood pH Serum phosphate Serum magnesium Serum bicarbonate Exogenous factors Citrate / free fatty acids (TPN) 5. [slideshare.net]
Involvement of the autonomic nervous system in the pathophysiology of Rett syndrome. Eur Child Adolesc Psychiatry. 1997 ; 6(suppl 1) : 42 – 45 ↵ Weese-Mayer DE, Boothby CM, Lieske SP, et al. [pediatrics.aappublications.org]
Pathophysiology of weakness in a patient with congenital end-plate acetylcholinesterase deficiency. Muscle Nerve 20 02; 25(4): 585 - 592 3. Hanada S, Kumashiro R, Kaji R, Harada M, Sata M. [neuro-tokushima.com]
Whereas the pathophysiology of muscular dystrophy 3 and the core myopathies 4 involves abnormal mitochondrial Ca 2+ handling, the phenotype associated with MICU1 deficiency is caused by a primary defect in mitochondrial Ca 2+ signaling, demonstrating [nature.com]
Prevention
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
We consider verapamil and lithium to be first-line preventives for chronic CH, although the trial evidence is at best Class II. [link.springer.com]
MICU1 acts both as an activator or inhibitor of mitochondrial calcium uptake: acts as a gatekeeper of MCU at low concentration of calcium, preventing channel opening; enhances MCU opening at high calcium concentration, allowing a rapid response of mitochondria [flybase.org]
Unfortunately, there are no preventive or curative measures for the disease to date. Dietary restriction is beneficial, but compliance is often limited. [pliem.co.za]
Patients require aids to maintain ambulation and prevent falling. [intranet.tdmu.edu.ua]