Muscular dystrophy (MD) is a group of genetic diseases involving progressive weakness and degeneration of the muscles that control movement. In some forms of MD, the heart muscles and other involuntary muscles, as well as other organs, are affected. There are 9 distinct types of MD. Myotonic MD is the most common form among adults, while Duchenne MD is the most common form among children (it affects only boys). MD is an incurable, often fatal disease.
Myotonic muscular dystrophy (which affects adults) is accompanied by the following signs and symptoms:
Although Duchenne MD is present at birth, signs and symptoms do not usually appear until the child is 3 - 5 years of age. They include:
Breathing difficulties and a chronic disorder of heart muscles develop during adolescence, usually after the individual becomes wheelchair bound.
MD is caused by gene mutations that are particular to each form of the disease.
In two thirds of cases of MD, the person has a family history. In one third of cases, there is no family history.
If you have symptoms of MD, you should see your health care provider. Diagnosis depends on sophisticated testing, such as lab tests, imaging, and other procedures.
The goal of a treatment plan is to maintain the person's optimal physical and emotional health by preventing joint and spinal deformities. This prolongs the ability to walk for as long as possible. Assisted breathing is introduced as needed, and lifelong physiotherapy is necessary. Orthopedic devices may be needed for support. Hydrotherapy, such as continuous tub baths, may help maintain a full range of joint motion. Physical, occupational, respiratory, and speech therapy may also help patients manage the symptoms of MD. Some clinicians recommend submaximum aerobic exercise, especially in the early course of the disease.
Your health care provider may prescribe the following medications:
Surgery sometimes can help people who have MD.
A comprehensive treatment plan for MD may include a range of complementary and alternative therapies.
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should consult with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.
Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for muscular dystrophy based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
Regular massage is important for reducing spasm and muscle contractions.
The outlook for people with MD varies, depending on the type and severity of the disease. In mild cases, the disease may progress slowly, and the person may have a normal lifespan. In more severe cases, there is a more marked progression of muscle weakness, functional disability, and loss of ability to get around. Duchenne MD patients usually live into their 20s, and myotonic MD patients usually live longer. In most cases, individuals with MD die of infections, respiratory problems, or cardiac failure.
MD patients undergo electrocardiography, pulmonary function studies, and chest radiographs annually along with tests to monitor their swallowing function.
Bushby K et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management. The Lancet Neurology. 2010;9(1).
Bushby K et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. The Lancet Neurology. 2010;9(2).
Dorchies OM, Wagner S, Vuadens O, et al. Green tea extract and its major polyphenol (-)-epigallocatechin gallate improve muscle function in a mouse model for Duchenne muscular dystrophy. Am J Physiol Cell Physiol. 2006;290(2):C616-25.
Escolar DM, Buyse G, Henricson E, et al. CINRG randomized controlled trial of creatine and glutamine in Duchenne muscular dystrophy. Ann Neurol. 2005;58(1):151-5.
Ferri: Ferri's Clinical Advisor 2010, 1st. ed. Philadelphia, PA: Mosby Elsevier. 2009.
Gulcin I. Antioxidant and antiradical activities of L-carnitine. Life Sci. 2006;78(8):803-11.
Kormosh N, Laktionov K, Antoshechkina M. Effect of a combination of extract from several plants on cell-mediated and humoral immunity of patients with advanced ovarian cancer. Phytother Res. 2006;20(5):424-5.
Manzur AY, Kinali M, Muntoni F. Update on the management of Duchenne muscular dystrophy. Arch Dis Child. 2008;93(11):986-90.
Mok E, Eléouet-Da Violante C, Daubrosse C, et al. Oral glutamine and amino acid supplementation inhibit whole-body protein degradation in children with Duchenne muscular dystrophy. Am J Clin Nutr. 2006;83(4):823-8.
Motlagh B, MacDonald JR, Tarnoplosky MA. Nutritional inadequacy in adults with muscular dystrophy. Muscle Nerve. 2005;31(6):713-8.
Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Muscular dystrophies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 608.
[No authors listed]. L-theanine. Monograph. Altern Med Rev. 2005;10(2):136-8.
Straathof CS, et al. Prednisone 10 days on/10 days off in patients with Duchenne muscular dystrophy. J Neurol. 2009;256(5):768-73.
Toscano A, Messina S, Campo GM, et al. Oxidative stress in myotonic dystrophy type 1. Free Radic Res. 2005;39(7):771-6.
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