Everything about Neuromuscular Disorders – Types, Causes & Symptoms
The neuromuscular system of the human body comprises the muscles and the nerves that transmit signals helping muscle movements (peripheral nervous system). Consequently, any abnormality in the neuromuscular system can lead to neuromuscular disorders causing numbness, weakness or even paralysis of different body parts.
In this article, you will find the different categories and types of neuromuscular disorders and their symptoms and progression.
What Is Neuromuscular Disorder?
Neuromuscular disorders comprise a wide-ranging category of diseases that affect the peripheral nervous system, consisting of motor and sensory nerves connecting the brain and spinal cord to the rest of the body. These disorders are predominantly characterised by progressive muscle weakness, wasting and function loss, along with other conditions.
These conditions are primarily genetic or due to problems arising in the immune system. Based on the cause and nature of the condition, neuromuscular disorders can of several types, which are classified under four broad categories:
- Muscular dystrophies
- Myopathies
- Neuromuscular junction disorders (myasthenic conditions)
- Motor and/or sensory neuropathies
What Are the Types of Neuromuscular Disorder?
The 10 most common types of neuromuscular disorders include the following:
1. Amyotrophic Lateral Sclerosis (ALS)
Also known as Lou Gehrig’s disease, it is a life-threatening disorder that has no cure. This condition brings about the stiffness of muscles, affecting all voluntary muscles. This is because the neurons that transmit signals from the brain to the upper and lower body parts die and their function ceases, ultimately leading to the failure of all body functions.
- Age at Onset: ALS can affect people of an age group but is most common between 40 and 70 years of age.
- Symptoms
Early Symptoms:
- Muscle cramps in arms, legs, shoulders, or tongue
- Stiffness of muscles (spasticity)
- Muscle cramps
- Muscle weakness affecting the limbs or diaphragm
- Slurred or nasal speech
Severe Symptoms:
- Difficulty chewing or swallowing
- Breathing difficulty
- Paralysis
- Rate of Progression: The progression rate varies from person to person. It may range from 1-3 years to 5-10 years, the latter being rare.
- Life Expectancy: The average life expectancy is 3 years. However, about 20% of the people live up to 5 years, and 10% live up to 10 years.
2. Duchenne Muscular Dystrophy (DMD)
DMD is a genetic condition affecting muscles leading to progressive wasting. It mainly occurs in males and affects females on rare occasions.
Age at Onset
Between 2-6 years.
- Symptoms
- Muscle weakness mainly in upper arms, pelvis and upper legs.
- Frequently falling down
- Trouble in running
- Trouble learning in some cases
- Wasting of voluntary muscles
- Rate of Progression
The progression rate is rapid.
Life Expectancy: Affected people survive only till their 20s or 30s.
3. Congenital Myopathy
It is an inherited genetic condition that occurs from birth, affecting all voluntary muscles of the body, including the ones associated with swallowing and breathing.
Age at Onset
Occurs right from birth.
- Symptoms
- Feeding and breathing problems
- Weak bones (osteopenia)
- Poor skeletal conditions, such as sideways curvature of the spine (scoliosis)
- Hip problems
- Rate of Progression
Progression is slow but causes shortened life span depending on the type and severity of the condition.
4. Charcot-Marie-Tooth disease
Charcot-Marie-Tooth (CMT) disease is a condition that affects the nerves. It is an inherited disorder that causes anomalies in the nerves mainly related to your feet, legs, and rarely hands and arms. It affects both sensory and motor nerves.
Age at onset
Onset age is typically between 5 to 25 years.
- Symptoms
- Loss of sensation
- Joint contractures
- Muscle weakness and atrophy
- Poor balance and coordination
- Loss of fine motor movements in case of affected hands
- Scoliosis
- Rate of Progression
The progression rate is gradual.
Life Expectancy: Life expectancy is not affected.
5. Emery–Dreifuss Muscular Dystrophy
Emery–Dreifuss muscular dystrophy is one of the other heritable neuromuscular diseases causing progressive impairment of muscles. It is mainly caused by genetic mutation and affects skeletal muscles used for movement as well as cardiac muscles used for heart pumping.
Age at onset
The average age of onset is about 10 years.
- Symptoms
- Joint contractures
- Muscle weakness in shoulders, shin, etc.
- Heart complication
- Rate of Progression
The rate of progression is gradual.
Life Expectancy: People developing cardiac issues due to muscle failure have an increased chance of sudden death.
6. Facioscapulohumeral Muscular Dystrophy
This type of muscular dystrophy mainly causes muscle weakness and atrophy in the facial muscles, scapula and upper arm (humerus), as indicated in its name.
Age at Onset
Generally, symptoms appear in late childhood to early adulthood.
- Symptoms
- Weakness in facial muscles
- Weakness in the shoulder (mainly shoulder blades)
- Scoliosis
- Vision loss due to structural changes in the blood vessels (Coats disease)
- Pain or swelling of joints and muscles
- Weakness in the hips, abdominal region or upper legs
- Rate of Progression
Slow progression with periods of rapid degeneration
Life Expectancy: Life expectancy is not shortened, but the severity may vary from person to person.
7. Myasthenia Gravis
Myasthenia gravis is an autoimmune disease characterised by inflammation throughout the body. This condition occurs when the immune system attacks the body's own acetylcholine receptors, reducing muscle contractions.
Age at Onset
It can occur at any age but is more frequent from 40 to 60 years.
- Symptoms
- Weakness in arms, legs, eyes and face
- Double vision or droopy eyelids
- Trouble swallowing or in speech
- Difficulty in breathing
- Rate of Progression
The progression rate is slow
Life Expectancy: Life expectancy is not affected, and people can continue living active life for years.
8. Multiple Sclerosis
Multiple sclerosis, also known as MS, occurs when the patient's immune system attacks the neuroprotective myelin sheath. Myelin is made up of fatty tissue that surrounds the nerve cells. The damage and resulting scar tissue around nerve fibres prevent impulses from being conducted from the brain, preventing nerves from functioning correctly.
9. Oculopharyngeal Muscular Dystrophy (OPMD)
Oculopharyngeal muscular dystrophy is a hereditary condition and an autosomal dominant disease. It affects the skeletal muscles (mainly ocular and pharyngeal muscles) and the proximal extremities.
Age at Onset
This condition has a late onset, usually between 40 to 70 years.
- Symptoms
- Droopy eyelids
- Facial muscle weakness
- Leg and arm weakness
- Choking or swallowing issues (dysphagia), especially for dry foods
- Shrinking of the tongue
- Saliva pooling
- Rate of Progression
The progression rate is slow.
Life Expectancy: Life span is not affected.
10. Spinal Muscular Atrophy (SMA)
This type of neuromuscular disorder is a hereditary condition produced by a genetic mutation that damages the protein required for regular motor neuron activity. There are various different types of SMA, with varying onset ages.
Age at Onset
Onset ages range from childhood and adolescence to maturity.
- Symptoms
- Problems in swallowing food
- Muscle weakness
- Inability to stand or walk
- Numbness in certain parts
- Diminished muscle tone (Hypotonia)
- Respiratory issues
- Involuntary contractions or muscle twitching
- Scoliosis
- Reduced or absence of deep tendon reflexes
- Rate of Progression
The rate of progression is slow.
Life Expectancy: Life expectancy may get affected, especially if the respiratory muscles are affected.
Neuromuscular disorders consist of a wide range of disorders that affect the muscles and functions of different parts of your body. While only some of these are treatable, all of them can be managed by timely medical intervention. Therefore, if you notice any of these common symptoms, do consult a professional immediately.
Frequently Asked Questions
Do all neuromuscular disorders have common symptoms?
Most neuromuscular diseases have a few common symptoms, such as muscle weakness, wasting, inability to move or numbness of limbs, as they are mainly caused by peripheral nerve damage. However, depending on the disease site and the patient's age, symptoms may differ.
Are neuromuscular diseases treatable?
Depending on the type and severity, treatment and curability of neuromuscular disorders may vary. Some may not be treatable; however, with advanced treatment and early diagnosis, mobility and quality of life may be improved.