The type of muscular dystrophy that develops as a result of impaired metabolism and minimized access of nutrition to vital tissues is called hypotrophy. Because nutrition is controlled by leptin through the feeling of satiety, this pathology is affiliated with the fat cell hormone. Muscle hypotrophy is quite a dangerous condition and can cause disability. You will learn about how it is diagnosed and treated in this article.
- General information.
- Triggers and types of pathology.
- Muscular hypotrophy of the upper extremities.
Muscle hypotrophy is a kind of metabolic muscular dystrophy. The blockage of the normal delivery of nutrients to the tissues causes degenerative processes in the muscles, threatening disability.
Therefore, the correction of such pathology has a special place in inpatient treatment and all conditions are created for it, namely:
- comfortable wards, oriented to the peculiarities of the disease;
- specialized high-class equipment;
- comprehensive approach to the correction of the disease;
- constant communication with patients’ relatives.
Complicated cases of hypotrophy are solved collegially. Neurologists analyze the situation using the results of a detailed examination of patients. The choice of correction methods is also made individually, taking into account the root cause of the pathology. An important role is given to the rehabilitation period, which speeds up the restoration of muscle functions.
Triggers and types of pathology
The main trigger of the disease is usually considered a deficiency of nutrients in the tissues. Minimization of muscle mass occurs due to infections, intoxications, metabolic disorders of burn disease, frostbite, chemical poisoning, and prolonged compression syndrome. Hypotrophy of the muscles of the lower extremities is formed in the form of complications against the background of injuries to peripheral nerves, tendons. The pathology can accompany paralysis.
There are several types of the pathological condition. The congenital form is formed in:
- Pregnancy, as a result of the growing fetus’s impaired blood supply to the lower extremities.
- An infectious process in the body of the expectant mother.
- Irrational nutrition of the pregnant woman.
- Unhealthy habits of the woman during pregnancy.
The acquired form of the disease forms:
- as a post-traumatic reaction after childbirth;
- from an unbalanced diet of the infant;
- due to metabolic disorders;
- as a result of malfunction of endocrine glands, including the fat layer that produces leptin;
- in old age as a consequence of low mobility of the person.
The most common variant of the pathology in adults is considered to be hypotrophy of the hip muscles. The cause may be trauma or age-related degeneration of the hip joint, coxarthrosis. In young children, hypotrophy of the lower leg is more often formed as a result of a lack of a balanced diet or injury. In the risk group of muscular hypotrophy are athletes who have stopped intensive exercises, office clerks, cashiers, IT-specialists, who deal with computer equipment most of the time. Muscle hypotrophy is a characteristic sign of peripheral nerve disease, and accompanies flaccid paralysis in poliomyelitis.
Muscular atrophy progresses gradually in:
- genetically determined diseases of muscle tissue;
- impaired metabolism;
- chronic infectious processes;
- prolonged use of hormones;
- changes in the trophics controlled by the nervous system.
Limited muscle hypotrophy occurs when there is a long period without movement due to destruction of tendons, nerve trunks, muscles, arthritis and arthrosis.
A number of variants of muscular dystrophy are distinguished:
- Minimization of the hypodermis in the whole body with a loss of about 20% of the muscle mass. In this case there is loss of appetite, weakness, pallor, low muscle tone.
- Subcutaneous fat in the abdominal area almost melts, the skin acquires a gray hue, the muscles become flabby, hepatomegaly is diagnosed, irritability and other mental disorders occur.
- Severe emaciation or cachexia is diagnosed with a loss of muscle mass of more than 30% and requires emergency measures to prevent a fatal outcome.
Common signs of adult hypotrophy include:
- chronic fatigue syndrome;
- significant weight loss;
- inability to perform simple movements.
If the hypotrophic areas are symmetrical, we speak about myopathy or spinal amyotrophy. In progressive muscular dystrophy, relatively isolated hypotrophy of the biceps and quadriceps muscles of the thigh is diagnosed. If the foci of hypotrophy are localized in remote parts of the limbs, we can think of polyneuropathy with impaired sensitivity and loss of reflexes (Steinert’s dystrophy).
Isolated muscle hypotrophy, localized on one side, of an acquired nature is always a consequence of a radicular syndrome, plexus or peripheral nerve lesion along its entire length. The main thing for the topical diagnosis is the localization of the foci of hypotrophy with impaired sensitivity or long inactivity of the musculature. Hypotrophy of the quadriceps muscle – accompanies knee osteoarthritis and sarcoma of the hip. Areas of hypotrophy of individual muscles can grow for a long time, which is considered a sign of focal lesion of the ganglion cells of the anterior horns or lack of blood flow in the arterial feeding zone. Doctors often encounter hypotrophy of the calf muscles as well.
Muscular hypotrophy of the upper extremities
This pathology is secondary in nature and deserves special attention. It is caused by impaired innervation or blood supply to a certain area of the tissue. But it can also act as a root cause, for example, in myopathy. Then the ability to move is preserved.
Several triggers of hand muscle hypotrophy can be distinguished:
- constant physical hyperexertion;
- radial wrist pathology;
- endocrine diseases affiliated with insulin- and leptin-resistance;
- post-traumatic scarring;
- systemic collagenoses;
- congenital anomalies.
The main symptom of the pathology is symmetry of the lesion and slow progress against the background of hypotrophy of the affected muscles and minimization of tendon reflexes with preserved sensitivity.
Hypotrophy of the arm muscles begins in the distal parts of the arm, the arm becomes monkey-like with complete loss of tendon reflexes and with preserved sensitivity in the affected limb. As the pathology progresses, the muscles of the trunk and neck become involved.
Making a diagnosis does not cause much difficulty due to the presence of special equipment, which makes it possible to perform electromyography and biopsy of the affected muscles. The patient is prescribed at the same time screening blood and urine tests, biochemical testing, hormonal profile. Activity of muscle enzymes is determined in blood serum, amount of creatine and creatinine is determined in urine. CT or MRI of the cervico-thoracic spine and brain may be indicated.
The correction of the pathology is complex. The goal is to eliminate the cause of the disease. Angioprotectors (Trental, Pentoxifylline, Curantil), low molecular weight dextran, prostaglandin E preparations are used to improve blood flow in the periphery. Vasadilators (No-shpa, Papaverine) restore normal blood supply of tissues with oxygen and nutrients. B vitamins balance metabolic processes and nerve impulse conduction. Biogenic stimulants such as aloe activate. Proserine, Galantamine, Armin are used for restoration of muscle conduction.
Modern correction of hypotrophy is unthinkable without physical therapy and therapeutic exercise. They use acupuncture, magneto- and electrostimulation therapy.
- activate the work of the muscles in denervation;
- support the contractile ability of muscles;
- balance the blood flow.
Such procedures activate the rehabilitation of injured nerve fibers, reduce psycho-emotional and physical overstrain, normalize the patient’s neuropsychological condition. Physiotherapy is very common as a biostimulant in the form of laser manipulations, ionophoresis sessions with Proserine, Galantamine. If the cause of low muscle tone in the arms and legs is a stroke, ONMK (acute violation of cerebral circulation) physiotherapy is also appropriate.
In ischemic stroke, it is connected early enough to improve the oxygen supply of tissues their nutrition, the balance of muscle tone, kupirovanie spasm of blood vessels It helps to return the sensitivity of the dermis, activity of movements. Prescription:
- limb massage;
- magneto- or electrostimulation of the limbs on the paresis side;
- low-intensity magnetic fields on the lower or upper extremities.
A month and a half after the disease onset electrophoresis of vasodilators, muscle relaxants, magneto- and laser therapy in red range is recommended. In hemorrhagic stroke physiotherapy is connected at a later date, after exclusion of contraindications. Apply limb massage, electrical stimulation, phototherapy. In degenerative hypotrophy, Prozerin or Glantamine electrophoresis on the affected muscle area, magnetotherapy, electrostimulation, pulsed UHF-therapy are used.
In tunnel syndromes with compression of nerve fibers in anatomical canals, in the acute period we perform electrophoresis and ultraphonophoresis of anesthetics, anti-inflammatory drugs, and magnetotherapy. When pain is minimized, heat therapy, percutaneous electrical muscle stimulation, and cryotherapy are used. LFC is important during rehabilitation, which includes kinesotherapy, mechanotherapy, orthotherapy, and ergotherapy. Additionally chiropractic therapy may be involved.