Amyotrophy
Causes and symptoms of muscle atrophy, diagnosis and treatment
What is Muscle Atrophy?
The process of muscle atrophy develops gradually and leads to an increasing decrease in their volume and the degeneration of muscle fibers, which become thinner, in especially severe cases their number can be reduced to complete disappearance. There are primary (simple) and secondary (neurogenic) muscle atrophy.
As a result of the development of muscle atrophy in the human body, a decrease, deformation of muscle tissue begins, its replacement with a connective tissue, unable to perform motor function. Muscle strength is lost, muscle tone falls, which leads to limitation of motor activity or its complete loss.
Causes of muscle atrophy
Primary muscle atrophy is caused by damage to the muscle itself. The cause of the disease in this case may be an unfavorable heredity, which is expressed in metabolic disorders in the form of a congenital defect in muscle enzymes or high permeability of cell membranes. Environmental factors that provoke the onset of the pathological process also have a significant impact. These include physical stress, infectious process, trauma. The most pronounced primary muscle atrophy in myopathy.
Muscle atrophy can be caused by trauma to the nerve trunks, an infectious process that affects the motor cells of the spinal cord, such as polio and poliomyelitis-like diseases.
Sometimes the pathological process is hereditary. In this case, the distal parts of the limbs are affected, and the process itself proceeds more slowly and is benign in nature.
In the etiology of the disease, the following factors are distinguished: malignant tumors, paralysis of the spinal cord or peripheral nerves. Often, muscle atrophy develops against the background of various injuries, starvation, intoxication, as a result of a slowdown in metabolic processes as the body ages, prolonged motor inactivity for any reason, as a consequence of chronic diseases.
If the spinal cord and large nerve trunks are affected, then neuropathic muscle atrophy develops. With thrombosis of large vessels or impaired blood flow in muscle tissue as a result of mechanical or pathological damage, an ischemic form develops. The reason for the functional form is absolute, often partial, motor inactivity due to pathological processes in the body - arthritis, poliomyelitis and poliomyelitis-like diseases.
Symptoms of muscle atrophy
There are two forms of the disease:
- The disease is diagnosed as primary if the muscle itself is directly affected. Heredity plays an important role in pathogenesis, often develops as a result of trauma or as a consequence of bruises, intoxication, and physical fatigue. It is clinically expressed by rapid fatigue, a noticeable decrease in muscle tone. There may be characteristic twitching of the limbs.
- Secondary muscle atrophy develops more often, as a post-traumatic complication or after various infections. As a result, motor cells are damaged, which leads to limitation of the motor function of the feet, legs, hands, forearm, partial or complete paralysis. Basically, the disease has a sluggish course, but there are periods of acute outbreaks of the disease, accompanied by severe pain.
Secondary muscle atrophy is divided into:
Neural myotrophy - with this form, the muscles of the feet and lower legs are affected, their deformation occurs. The patient's gait changes. To prevent hanging feet from touching the floor, he begins to raise his knees high. Superficial sensitivity is lost, and reflexes fade away. Several years after the onset of the disease, the disease spreads to the hands and forearms.
The most severe and complex course is observed with progressive muscle atrophy, most often manifested already in early childhood, and in a family with healthy parents. This form is characterized by a complete loss of tendon reflexes, a sharp decrease in blood pressure. Fibrillar twitching of the limbs is often observed.
Progressive muscular atrophy develops in adults and is called atrophic syndrome. In this case, the distal or distal parts of the upper extremities are affected - fingers, interosseous muscles of the hand. The hand takes on a specific appearance, it looks like a monkey. Tendon reflexes disappear, but sensitivity remains. With the further development of the disease, the muscles of the neck and trunk are included in the pathological process.
A common symptom for all types of muscle atrophy is a decrease in the volume of the damaged muscle, which is especially noticeable when compared with the healthy side. The severity of symptoms depends on the severity and prevalence of the disease, in all cases leads to a decrease in muscle tone and pain on palpation of the limbs.
Diagnosis of muscle atrophy
Diagnosis of muscle atrophy is currently not difficult. To identify the background cause of the onset of the disease, detailed clinical and biochemical blood tests, functional studies of the thyroid gland and liver are performed. Electromyography and a study of nerve conduction, a biopsy of muscle tissue, and a thorough history are required. If necessary, additional examination methods are prescribed.
Forms of muscle atrophy
There are several forms of the disease. Neural amyotrophy, or Charcot-Marie amyotrophy, occurs with lesions of the muscles of the foot and lower leg, the most susceptible to the pathological process are the group of extensors and the group of the muscles abducting the foot. At the same time, the feet are deformed. Patients develop a characteristic gait, during which patients raise their knees high, since the foot, during the raising of the leg, sags and interferes with walking. The doctor notes the extinction of reflexes, a decrease in surface sensitivity in the lower extremities. Years after the onset of the disease, the hands and forearms are involved in the pathological process.
Werdnig-Hoffmann's progressive muscle atrophy is characterized by a more severe course. The first symptoms of muscle atrophy appear in a child at an early age, often in a family of apparently healthy parents, several children suffer from the disease at once. The disease is characterized by loss of tendon reflexes, a sharp decrease in blood pressure, fibrillar twitching.
Atrophic syndrome also accompanies progressive muscular atrophy of adults - Aran-Duchenne atrophy. At the initial stage, the pathological process is localized in the distal parts of the upper extremities. Muscle atrophy also affects the eminence of the thumb, little finger, and the interosseous muscles. Patients' hands assume the characteristic "monkey hand" posture. Pathology is also accompanied by the disappearance of tendon reflexes, but the sensitivity remains. The pathological process progresses over time, it involves the muscles of the neck and trunk.
Muscle Atrophy Treatment
When choosing a treatment method, important factors must be taken into account: the patient's age, the severity and form of the disease. The main importance is attached to the treatment of the underlying disease, which led to the development of muscle atrophy. Medical treatment is carried out and additional treatment is prescribed: physiotherapy procedures, electrotherapy, therapeutic massage and gymnastics. Strict adherence to all the recommendations and requirements of the doctor allows many patients to regain lost motor abilities and slow down the atrophy process.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
