Neuromuscular disease

Neuromuscular disease
MeSH	D009468

Overview

Neuromuscular disease is a very broad term that encompasses many diseases and ailments that either directly (via intrinsic muscle pathology) or indirectly (animal muscle in general.

Neuromuscular diseases are those that affect the muscles and/or their nervous control. In general, problems with nervous control can cause spasticity or paralysis, depending on the location and nature of the problem. A large proportion of neurological disorders leads to problems with movement, ranging from cerebrovascular accident (stroke) and Parkinson's disease to Creutzfeldt-Jakob disease.

Causes

• Diseases of the motor end plate include
  • Myasthenia gravis, a form of muscle weakness due to antibodies to the acetylcholine receptor, and its related condition
  • Lambert-Eaton myasthenic syndrome (LEMS)
  • Tetanus
  • Botulism
• The myopathies are all diseases affecting the muscle itself, rather than its nervous control.
  • Muscular dystrophy leads to progressive loss of strength, high dependence and decreased life span.
  • [Inflammatory]] muscle disorders
    • Polymyalgia rheumatica (or "muscle rheumatism") is an inflammatory condition that mainly occurs in the elderly
    • Polymyositis
    • Dermatomyositis
    • Inclusion body myositis
  • Other causes
    • Tumors of muscle
      • Smooth muscle: leiomyoma (benign, very common in the uterus), leiomyosarcoma (malignant, very rare)
      • Striated muscle: rhabdomyoma (benign) and rhabdomyosarcoma (malignant) - both very rare
      • Metastasis from elsewhere (e.g. lung cancer)
    • Injury Injuries - of muscles include wounds and strains.

Symptoms

Symptoms of muscle disease may include

• Weakness or
• Spasticity/rigidity
• Myoclonus
• myalgia (muscle pain).

Laboratory Findings

Diagnostic procedures that may reveal muscular disorders include testing creatine kinase levels in the blood and electromyography (measuring electrical activity in muscles).

ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)

Recommendations for Neuromuscular Disorders

Class I

"1. Patients with neuromuscular disorders who have ventricular arrhythmias should generally be treated in the same manner as patients without neuromuscular disorders. (Level of Evidence: A). "

Class IIa

"1. Permanent pacemaker insertion may be considered for neuromuscular diseases such as myotonic muscular dystrophy, Kearns-Sayre syndrome, Erb dystrophy, and peroneal muscular atrophy with any degree of AV block (including first-degree AV block) with or without symptoms, because there may be unpredictable progression of AV conduction disease. (Level of Evidence: B)"

Related Chapters

• Muscle
• ICD-10_Chapter_XIII:_Diseases_of_the_musculoskeletal_system_and_connective_tissue
• Centronuclear myopathy
• Myotubular myopathy