Friday, February 14, 2014

Myotonic Dystrophy and Foot Deformities

Myotonic dystrophy is one of the most common myopathies and is inherited through an autosomal dominant gene. Often, many members of the same family have this condition.
The manifestation of this disease does not appear until late adolescence or early adulthood. Early symptoms include muscle stiffness, cramping pains, or difficulty relaxing the grasp. Diagnosis is usually made through an electromyogram.
Characteristics of fully developed myotonic include long, thin, facial expressions with temporal and masseter weakness and frontal balding. The neck will look like a long swan's neck due to the weakness of the musculature. The voice has a nasal quality and speech can become dysarthric, meaning trouble pronouncing words. Swallowing may also be impaired. Cataracts and endocrine abnormalities, like disturbances of the adrenal, pancreatic, and gonadal function are also affected. In men, testicular atrophy is seen, and in females infertility.
Myotonic dystrophy should not be confused with myotonia congenita, also known as Thomsen's disease. In Thomsen's disease there is stiffness of the muscle with difficult in initial movements. No atrophy or mental retardation is found, with no physical limitation. After activity, the muscles loosen, and the patient's movements are almost normal.
Foot and ankle weakness presents early and is associated with stiffness and cramping pains. In general, foot deformities are not severe enough to need surgical correction. Treatment is directed towards the modification of the shoe. Shoe lifts, pads, and wedges are used to help prevent painful feet and aid with gait. If the patient is able to keep up strength in their legs, footdrop can be alleviated by orthotics.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
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