NEUROMUSCULAR DISEASE Symptoms and

Neuromuscular disease is a very broad term that encompasses

many diseases and ailments that either directly, via intrinsic muscle
testing
pathology, or indirectly, via nerve pathology, impairs the
functioning of the muscles. Symptoms of muscle disease
may include muscular
Neuromuscular diseases are those that affect the muscles and/or weakness, spasticity/rigidity,
their nervous control. In general, problems with nervous control can loss of muscular control,
cause either spasticity or some degree of paralysis, depending on the
myoclonus (twitching,
location and the nature of the problem. A large proportion of
neurological disorders lead to problems with movement. Some spasming), and myalgia
examples of these disorders include cerebrovascular accident (muscle pain). Diagnostic
(stroke), Parkinson's disease, multiple sclerosis, myasthenia gravis, procedures that may reveal
Huntington's disease (Huntington's chorea), and the Creutzfeldt- muscular disorders include
Jakob disease.
direct clinical observations
(above all), the testing of
various chemical and

Causes, including autoimmune antigen levels in the blood,

and electromyography
diseases and poisoning (measuring electrical activity
in muscles). Diagnostic
Neuromuscular disease can be caused by circulatory problems imaging may be helpful in
(strokes, etc.), immunological and autoimmune disorders, the failure certain cases, such as those
of the electrical insulation surrounding nerves myelin, caused by strokes or tumors.
genetic/hereditary disorders, such as Huntington's disease, certain
rare tumors, the failure of the connections between the nerves and
the muscle fibers, exposure to pernicious environmental chemicals,
poisoning - including heavy-metal poisoning, and importantly,
unknown causes. The failure of the electrical insulation surrounding
nerves, the myelin, is seen in certain deficiency diseases, such as the
failure of the body's system for absorbing vitamin B-12, and also the
failure of the myelin is seen in multiple sclerosis and some other
neurological diseases, especially in autoimmune diseases that are
thought to attack the myelin.

Some neuromuscular diseases are hypothesized to be caused either

by viral infections or by attack by little-known pernicious proteins
called prions.

Diseases of the motor end plate include myasthenia gravis, a form

of muscle weakness due to antibodies to the acetylcholine receptor,
and its related condition Lambert-Eaton myasthenic syndrome
(LEMS). Tetanus and botulism are bacterial infections in which
bacterial toxins cause increased or decreased muscle tone,
respectively.
The myopathies are all diseases primarily resulting in muscular degeneration, rather than affecting the
nerves themselves.

The Muscular dystrophies, including Duchesne’s and Becker's, are a large group of diseases, many of
them hereditary or resulting from genetic errors, where the muscle integrity is disrupted. They lead to
progressive loss of strength and decreased life span.

Inflammatory muscle disorders

 Polymyalgia rheumatica (or "muscle rheumatism") is an inflammatory condition that mainly

occurs in the elderly; it is associated with giant-cell arteritis. It often responds dramatically to
glucocorticoids (e.g. prednisolone).
 Polymyositis, dermatomyositis and inclusion body myositis are autoimmune conditions in which
the muscle is affected.
 Rhabdomyolysis is the breakdown of muscular tissue due to any cause. While it may not lead to
any muscular symptoms at all, the myoglobin thus released may cause acute renal failure.

Tumors
Tumors of muscle are of the soft tissue sarcoma group and include:
• Smooth muscle: leiomyoma (benign, very common in the uterus), leiomyosarcoma (malignant, very
rare)
• Striated muscle: rhabdomyoma (benign) and rhabdomyosarcoma (malignant) - both very rare
• Metastasis from elsewhere (e.g. lung cancer)
•
Smooth muscle has been implicated to play a role in a large number of diseases affecting blood vessels, the
respiratory tract (e.g., asthma), the digestive system (e.g. irritable bowel syndrome) and the urinary tract
(e.g., urinary incontinence). These disease processes are not usually confined to the muscular tissue. In
general, muscle tumors are rare, since muscle cells are not constantly dividing cells.

Tumors of the thymus gland are implicated in some cases of myasthenia gravis and other neuromuscular
diseases.

Tumors of the peripheral nervous system are known, but rare, because nerve cells are not ones that divide
very much under normal circumstances.