What is Neuromuscular Disease?

Neuromuscular diseases are acquired or inherited conditions that affect some part of the nervous system such as

  1. The muscles
  2. The peripheral nerves (in arms, legs, neck & face)
  • The neuromuscular junction where the nerves and muscles meet
  1. The muscle controlling nerve cells (motor neurons) in the spinal cord

What are the diseases seen in Neuromuscular clinic?

  1. Diseases of muscles: Congenital Myopathies
    • Muscular Dystrophies –­Duchenne, Bechet’s, Limb girdle Muscular Dystrophy
    • Inflammatory Myopathis-Polymyositis, Dermatomyositis
    • Metabolic Myopathis- Diabetes, Hypothyroidism, Drug induced, Renal/Hepatic Failure
    • Periodic Paralysis
  2. Diseases of Nerves: Neuropathies
    • Diabetes Mellitus
    • Connective tissue disease (RA, SLE)
    • Infection –Diphtheria, Lyme Disease, HIV, HCV, HBV
    • Immuno-allergic- AIDP, CIDP
    • Toxins- a) Drugs- Anti TB, Anti-Cancer, AED
  1. b) Poison- Lead, Arsenic, Mercury, Organo-Phosphorous
  • Metabolic- Porphyria, Uremia, Thyrotoxicosis
  • Nutritional- Beriberi, Vitamin B12, Folate & B6 Deficiency
  • Neoplastic Infiltration- Carcinoma, Lymphoma, Myeloma
  • Inherited Neuropathies
  1. Diseases of Neuromuscular Junction: Myasthenia Gravis, Eaton- Lambert Syndrome

What are the different types of pain symptoms complaints by the Patients?

  • Pins & Needle sensation
  • Stabbing sensation
  • Tingling, Pricking
  • Electric Current like
  • Burning, Aching
  • Sharp & Cutting

Pain is common in diabetic and alcoholic-nutritional neuropathy

Herpes Zoster infection- Dermatomal distribution

Traumatic

How common is Neuropathy in diabetes?

15% of diabetic patient suffer symptoms of neuropathy at presentation and 50% have NCV abnormalities. 50% of patients develop neuropathy after 25 years of Diabetes. Incidence is high in Type I DM (54%)

 

What are the different diagnostic tests for these neuromuscular disorders?

  1. Proper history and clinical examination
  2. Routine blood tests- Glucose, Thyroid hormone level, Enzyme CPK, Vitamins level, Collagen Vascular disease profile (selected cases)
  • Nerve Conduction Velocity test- To find out conduction of electrical impulse in selected Peripheral Nerves
  1. EMG (Electromyography) – Useful tests for Myopathies, Muscular Dystrophies, and Motor Neuron diseases.
  2. Nerve & Muscle Biopsy- Useful in Peripheral neuropathy and Myopathies & Muscular Dystrophies
  3. MRI of spine- Useful in Disc Prolapse, Infection, Cancer Infiltration of Spine, Spinal cord Tumor etc.
  • Genetic test- Useful in Hereditary diseases, Muscular dystrophy, Limb Girdle Muscular Dystrophy, Congenital Myopathies & Neuropathies.

What is the role of Physiotherapy in these diseases?

Physiotherapy has got tremendous role in Neurological disorders. It is useful in Spinal disc disorders, Neuropathies, Myopathies, Muscular Dystrophies and any conditions with deformities of spine and body. Physiotherapy is also very much useful in pain management.

 

 

 

 

 

 

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