MUSCLE DISEASES
Dr HEEWA A. YOUNIS1 st NOV. 2014
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Preface
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PREFACE
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CATEGORIZATION :
A- PRIMARY MUSCLE DISEASES:I- Muscular Dystrophy:
Group of hereditary muscle disease characterized by progressive muscle weakness of skeletal muscle due to defect in muscle protein leading to death of the muscle cell & tissue.
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1-Duchenne Muscular Dystrophy:
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2- Becker Muscular Dystrohy:
63- Limb Girdle Muscular Dystrophy (LGMD):
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4- Facioscapulohumeral Dstrophy (FSH):
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5- Emery Driefuss Muscular Dystrophy(EDMD):
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6- Ocular Muscular Dystrophy (OMD): 7- Oculopharyngeal Muscular Dystrophy (OPMD):
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8- Distal Muscular Dystrophy:
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9- Paraspinal Muacular Dystrophy:
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10- Myotonia Dystrophica:
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II- Congenital Myopathies:
Nemaline Myopathy.Central Core Myopathy.
Myotubular Myopathy.
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III- Mitochondrial Myopathies:
1- MERRF2- MELAS
3- MNGIE:
4- KSS
5- CPEO
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IV- Inherited Metabolic Myopathy
Carbohydrate Metabolism Myopathies.Lipid Metabolism Myopathies.
present with exercise induced Muscle pain, Myoglobinuria.
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V- Inflammatory Myopathies:
Acquired,Subacute or Chr.
Inflammatory,
Autoimmune Muscle diseases include:
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1- Polymyositis (PM):
F=Many age
proximal limb & girdle muscles are Painful, Tender
Dysphagia
Respiratory Difficulty
Raynaud Phenomena
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Polymyositis (PM):
Arthralgia,
Fever, and Weight Loss
SLE, Scleroderma, Rheumatoid Arthritis, Sjogren Syndrome.Malignancy assoc.
19Dermatomyositis (DM)
F>M(skin changes)
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Inclusion Body Myositis (IBM):
M>FInsidious onset usually after age of 50yr,
Painless
Refractory
Early weakness of knee extension with loss of knee jerk then spread to upper limb finger flexors
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IBM
(Proximal LL & Distal UL)( Myopathy & Neuropathy)
Etiology:
genetic
autoimmune
diabetes
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Investigations
Muscle Enzymes:
CPK
LDH
ALT
AST
ALDOLASE
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EMG
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Muscle Biopsy
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4-
4- Search for associated disease mentioned above
5- Search for Malignancy in adults with PM. DM, IBM
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Treatment:
1- Antiinflammatory Drugs:Prednisolone tab. with potassium for 2-3 yr. If Fail :
Methotrexate or
Azathioprime or
Mycophenolate Mofetil.
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2- Immunoglobulin IV Ig.
3- Physical Therapy.31
11- SECONDARY MUSCLE DISEASES:
32VI- Metabolic & Endocrine Myopathy:
Osteomalacia.
Hypokalemia.
Hypercalcemia.
Thyroid Myopathy. (hyper & hypo)
Adrenal ( Cushing Syndrome, Addison disease & Conn’s Syndrome)
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VII- Drug Induced Myopathy:
Corticosteroids.Statins.
B- Blockers.Alcohol.
34VIII- - Infective Myopathy:
Virus Myositis
Toxoplasmosis.
Trichenosis..35
IX- Toxin Myopathy:
Alcohol.Organophosphorus.
Vitamin E.Snake Venom
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