Myopathy
Myopathies are defined as diseases of skeletal muscle and can have many causes. Accordingly, myopathies can present in a variety of ways, but one of the cardinal features is muscle weakness. Weakness can affect muscles of the eyes, face, arms, legs, trunk, swallowing, and breathing. While certain myopathies can present with muscle pains, cramps, and stiffness, these features are non-specific to myopathies and can be seen in many other diseases, including those outside the realm of neuromuscular disorders. The most common myopathies seen in the Neuromuscular Center are inflammatory myopathies, muscular dystrophies, metabolic myopathies, myopathies associated with systemic disorders, and myopathies due to certain medications.
Diagnosis
As with peripheral neuropathies and MG, the diagnosis of myopathies requires a neurologic history and examination. Laboratory tests are used to measure enzymes of the muscles and look for associated systemic disorders. While the EDX examination can play a diagnostic role, the ‘gold standard’ for most myopathies requires a muscle biopsy. This procedure is performed on an outpatient basis by an experienced physician.
Treatment
The treatment of myopathies is multidisciplinary and depends on the type of myopathy. Certain types of myopathies can be treated with immune-suppressant agents and IVIG. Most myopathies require the use of supportive services, such as physical and occupational therapy, pulmonary medicine, cardiology, dietary management, and speech/swallowing therapists. Surgical treatment of spine and limb deformities is used in long-standing cases.
Neuropathy
Neuropathy is a term that refers to general diseases or malfunctions of the nerves. Nerves at any location in the body can be damaged from injury or disease. Neuropathy is often classified according to the types or location of nerves that are affected. Neuropathy can also be classified according to the disease causing it. (For example, neuropathy from the effects of diabetes is called diabetic neuropathy.
Treatment
The treatment of neuropathy involves measures to control the symptoms as well as treatment measures that address the underlying cause of neuropathy, if appropriate. Medical treatments for diabetes, autoimmune diseases, infections, kidney disease, and vitamin deficiencies are varied and are directed at the specific underlying condition. In many cases, treatment of the underlying disease can reduce or eliminate the symptoms of neuropathy. Some cases, especially those involving compression or entrapment of nerves by tumors or other conditions, can be relieved by surgery.
Control of blood glucose (sugar) levels is important in the treatment of diabetic neuropathy to help prevent further damage to nerves.
Clinical trials are underway to help find new and more effective treatments for neuropathy. For example, treatments that involve electrical nerve stimulation or magnetic nerve stimulation are being studied.