Myotonic Dystrophy

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Myotonic Dystrophy


dystrophia myotnica
  • autosomal dominant
  • shows anticipation
    • increased severity with each generation
    • triplet repeat expansion

Clinical Features

  • usually becomes evident between 20-50 years
  •  
  • progressive distal weakness
  • ptosis
  • thinning of face / sternomastoids
  • myotonia
  • syndrome
    • cataracts
    • frontal baldness
    • mild intellectual impairment
    • cardiomyopathy and conduction defects
    • small pituitary fossa and hypogonadism
    • glucose intolerance
    • low serum IgG

Examination

  • may find it hard to release handshake
  • Observe
    • ptosis
    • myopathic facies
      • snarl
      • poor smile
      • probably unable to whistle
      • looks sad or simple
      • drooping mouth
    • temporal wasting
    • frontal balding
    • cataracts
  • Myotonia
    • slow relaxation of muscles
    • difficulty releasing grip
      • worse when cold
  • Power
    • weak, especially forearms
  • Reflexes
    • decreased
  • Higher Mental Function
    • low IQ
  • Endocrine

Investigations

  • ECG
    • cardiac conduction defects

Treatment

  • myotonia
    • phenytoin
    • procainamide
 

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