Review Article Address correspondence to Dr Alejandro Tobon, University Metabolic Myopathies of Texas Health Science Center San Antonio, 8300 Floyd Curl Alejandro Tobon, MD Drive, San Antonio, TX, 78229,
[email protected]. Relationship Disclosure: Dr Tobon reports no disclosure. ABSTRACT Unlabeled Use of Purpose of Review: The metabolic myopathies result from inborn errors of Products/Investigational metabolism affecting intracellular energy production due to defects in glycogen, Use Disclosure: Dr Tobon reports no disclosure. lipid, adenine nucleotides, and mitochondrial metabolism. This article provides an * 2013, American Academy overview of the most common metabolic myopathies. of Neurology. Recent Findings: Our knowledge of metabolic myopathies has expanded rapidly in recent years, providing us with major advances in the detection of genetic and biochemical defects. New and improved diagnostic tools are now available for some of these disorders, and targeted therapies for specific biochemical deficits have been developed (ie, enzyme replacement therapy for acid maltase deficiency). Summary: The diagnostic approach for patients with suspected metabolic myopathy should start with the recognition of a static or dynamic pattern (fixed versus exercise-induced weakness). Individual presentations vary according to age of onset and the severity of each particular biochemical dysfunction. Additional clinical clues include the presence of multisystem disease, family history, and laboratory characteristics. Appropriate investigations, timely