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Last updated: 04 January 2025 Print

Nemaline Myopathy (NM)

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Congenital MyopathiesNemaline Myopathy

Overview

  • Nemaline Myopathy (NM): A congenital myopathy characterized by rod-like inclusions (nemaline bodies) in skeletal muscle fibers.
  • Inheritance:
    • Autosomal dominant (AD), autosomal recessive (AR), or sporadic (new dominant mutations).

    Clinical Forms

    1. Typical Congenital NM

      • Onset: Birth or first year of life.
      • Features:
        • Hypotonia, weakness, feeding difficulties.
        • Delayed motor milestones, waddling gait, or speech abnormalities.
        • Facial weakness is common.
        • Weakness:
          • Both distal and proximal muscles (genetic subtype clue).
          • Respiratory muscle involvement (often subclinical hypoventilation).
        • Cardiac involvement: Rare.
      • Prognosis:
        • Muscle weakness often static or slowly progressive.
        • Most patients lead active lives.
    2. Severe Congenital NM

      • Onset: Birth.
      • Features:
        • Severe hypotonia, fetal akinesia, limited postnatal movement.
        • Feeding difficulties (sucking and swallowing issues).
        • Respiratory insufficiency and recurrent pneumonia.
      • Prognosis:
        • High mortality in first weeks/months due to respiratory failure.
        • Rare survivors may achieve independent walking.

    Diagnostic Features

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