Spinal Muscular Atrophy

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FACT SHEET SPINAL MUSCULAR ATROPHY Spinal Muscular Atrophy (SMA) is a Motor Neuron Disease. It is caused by the mutation of the Survival of SYMPTOMS IN INFANTS • Muscle weakness. Motor Neuron (SMN) gene. It occurs due to the loss of • Muscle atrophy (wasting). motor neurons within the spinal cord and brain. It results • Poor muscle tone. in the progressive wasting away of muscles (atrophy) and • Areflexia (delayed reflexes). muscle weakness. SMA can affect people of all ages, races • Weak cry. or genders; however, the majority of cases occur in infancy • Difficulty sucking or swallowing. or childhood. There are four types of SMA. • Feeding difficulties. FORMS OF SMA • Weak cough. • Lack of developmental milestones (inability to lift head TYPE I (ACUTE INFANTILE) or sit up). • Also called Wernig-Hoffman Disease. • Limpness or a tendency to flop. • Most severe form of SMA. • Accumulations of secretions in the lungs or throat. • Usually diagnosed before six months of age. • Those affected cannot sit without support, lungs may SYMPTOMS IN ADULTS not fully develop, swallowing and breathing may be • Muscle weakness. difficult and there is weakness of the intercostal muscles • Muscle atrophy (wasting). (muscles between the ribs). • Weak tongue. • 95 per cent fatal by 18 • Stiffness. • Cramps. TYPE II (CHRONIC INFANTILE) • Fasciculation (twitching). • Usually diagnosed before the age of two, with the • Clumsiness. majority of cases diagnosed by 15 months. • Dyspnea (shortness of breath). • May be able to sit without assistance or even stand with support. DIAGNOSIS • Increased risk for complications from respiratory • A diagnosis can be made by an SMN gene test which infections. determines whether there are any traces of the SMN1 • Usually do not live past 30 years of age. gene. TYPE III (CHRONIC JUVENILE) • When the SMN gene test is not possible or shows no abnormality, an electromyography (EMG) or muscle • Also known as Kugelberg-Welander or Juvenile Spinal biopsy can be done. Muscular Atrophy. • Usually diagnosed before the age of three but can strike TREATMENT as late as adolescence. • Physical and occupational therapy. • Able to walk but experience noticeable weakness. • Ventilation is crucial, as many infants with severe forms • Most patients eventually need to use a wheelchair. of SMA succumb to respiratory disease due to weakness of • Usually survive well into adulthood with normal life breathing muscles. expectancy. • Assistive devices, such as ventilators and power wheel- chairs, help those living with SMA live longer and fuller TYPE IV (ADULT ONSET) • Much less common than the other forms. OTHER FACTS • Symptoms tend to surface after the age 35 but sometimes earlier. • Lifespan depends on the severity of SMA in the patient. • The bulbar muscles – used for swallowing and • Intellectual ability is unaffected. respiratory function – are rarely affected. • Sexual response and reproductive functions are also • Progression is slow and those affected have a normal life unaffected. expectancy. PROVINCIAL OFFICE ALS SOCIETY OF ALBERTA EDMONTON OFFICE 7874 10 STREET NE WWW.ALSAB.CA 5418 97 STREET NW CALGARY, AB T2E 8W1 1-888-309-1111 EDMONTON, AB T6E 5C1.

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Gluteal Muscle Contracture: Diagnosis and Management Options
SICOT J 2017, 3,1 Ó The Authors, published by EDP Sciences, 2017 DOI: 10.1051/sicotj/2016036 Available online at: www.sicot-j.org REVIEW ARTICLE OPEN ACCESS Gluteal muscle contracture: diagnosis and management options Saroj Rai1, Chunqing Meng1,*, Xiaohong Wang1, Nabin Chaudhary2, Shengyang Jin1, Shuhua Yang1, and Hong Wang1 1 Department of Orthopedics, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, #1277 Jiefang Avenue, 430022 Wuhan, P.R. China 2 Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, #1095 Jiefang Avenue, 430030 Wuhan, P.R. China Received 14 April 2016, Accepted 29 October 2016, Published online 6 January 2017 Abstract – Gluteal muscle contracture (GMC), a debilitating disease, exists all over the globe but it is much more prevalent in China. Patients typically present with abduction and external rotation of the hip and are unable to bring both the knees together while squatting. Multiple etiologies have been postulated, the commonest being repeated intramuscular injection into the buttocks. The disease is diagnosed primarily by clinical features but radiological features are necessary for the exclusion of other pathological conditions. Non-operative treatment with physiotherapy can be tried before surgery is considered but it usually fails. Different surgical techniques have been described and claimed to have a better outcome of one over another but controversy still exists. Based on published literatures, the clinical outcome is exceptionally good in all established methods of surgery. However, endoscopic surgery is superior to conventional open surgery in terms of cosmetic outcome with fewer complications. Nevertheless, its use has been limited by lack of adequate knowledge, instrumentations, and some inherent limitations.
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