congenital muscular dystrophy
Congenital muscular dystrophies are a heterogeneous group of autosomal recessive myopathies presenting at birth with hypotonia, delayed motor development, and early onset of progressive muscle weakness, confirmed with a dystrophic pattern on muscle biopsy.
Clinical presentation
There is a wide spectrum of clinical manifestations in the different types of congenital muscular dystrophies, from a severe and often early fatal infant syndrome with feeding and respiratory troubles to a moderate motor delay and mild or moderate limb-girdle involvement during childhood compatible with survival into adult life . Common symptoms are:
- hypotonia (floppy baby)
- developmental delay
- seizures
- poor vision
Congenital muscular dystrophies are diagnosed by the analysis of the clinical severity and progression and confirmed by a muscle biopsy showing the presence of a dystrophic process without histological evidence of another neuromuscular disease .
Pathology
- mutations in molecules with roles in cell migration and connection or proteins involved in their processing, such as α-dystroglycan (a part of the dystrophin-glycoprotein complex) or its ligand, merosin/laminin α2
- autosomal recessive
- muscle biopsy: mild to moderate dystrophic changes, +/- inflammatory infiltrate, +/- absent staining laminin α2
Classification
- CMD 1: abnormal white matter varies from mild (CMD1 merosin positive) to moderate-severe (CMD 1 merosin negative)
- CMD 2: Fukuyama congenital muscular dystrophy (FCMD), moderate dysplasia of cerebral neocortex and cerebellum, abnormal white matter
- CMD 3: Santavuori muscle-eye-brain (MEB) Finnish-type, less severe than CMD 4, with ventriculomegaly, vermian hypogenesis, dysplastic cortex, patchy abnormal white matter +/- callosal dysgenesis
- CMD 4: Walker-Warburg syndrome, most severe, with cobblestone brain, massive ventriculomegaly with absent/abnormal callosum, no myelin, kinked pons midbrain, vermian hypoplasia +/- cephalocele
The latter types, CMD 2-4, belong to the group of dystroglycanopathies, which frequently have brain involvement.
Radiographic features
Described features in general include:
- cobblestone lissencephaly
- myelination defects
- Z-shaped/kinked, hypoplastic brainstem
- hypoplastic vermis
- ventriculomegaly
- dysgenesis of the corpus callosum
- small dysplastic cerebellar hemispheres with cortical microcysts
History and etymology
The condition was first described by the English neurologist Frederick Eustace Batten (1865-1918) in his publications in 1903 and 1904 .
See also
Siehe auch:
- Kongenitale Muskeldystrophie Typ Ullrich
- Muskeldystrophie Typ Fukuyama
- Kongenitale Muskeldystrophie mit rigid spine
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A3
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A2
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A5
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A6
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A1
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit Fehlbildungen des Gehirns und der Augen Typ A4
- Kongenitale Muskeldystrophie mit familiärer Epidermolysis bullosa simplex
- Kongenitale Muskeldystrophie mit Integrin-alpha-7-Mangel
- Kongenitale Muskeldystrophie mit LMNA-Mutation
- Kongenitale Muskeldystrophie-Dystroglykanopathie Typ B5
- Kongenitale Muskeldystrophie 1B
- Kongenitale Muskeldystrophie 1A
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit mentaler Retardierung Typ B6
- Kongenitale Muskeldystrophie-Dystroglykanopathie ohne mentale Retardierung Typ B4
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit mentaler Retardierung Typ B2
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit mentaler Retardierung Typ B1
- Congenital muscular dystrophy with joint hyperlaxity
- Kongenitale Muskeldystrophie-Dystroglykanopathie mit mentaler Retardierung Typ B3