Myopathic syndrome is a pathological condition, also known as phenopathy of myopathy. This is a complex of specific manifestations that is quite common in medical practice. Visual observation of the patient often suggests hereditary myopathy, but detailed examinations indicate that the symptoms are only provoked by some disease, not being the main disease.
What can provoke?
The causes of symptoms of myopathic syndromes are violations of the integrity and functionality of the internal secretory system, malfunctions of various glands. In some cases, the cause is an infectious disease, an allergic reaction of the body. A set of manifestations can be provoked by inherited and acquired disorders, metabolic pathologies.
Endocrine system
Myopathic syndrome is more often detected in children and adults against a background of thyroid gland disorders. In some cases, acute myopathy develops with severe thyrotoxicosis. At the same time, muscle weakness actively and aggressively progresses, observes paresis of certain muscles. Chronic myopathy with thyrotoxicosis can provoke a complex of symptoms. This form is more widespread. Its key differences are gradually progressive atrophy, paresis, more characteristic of the proximal limbs. Possible weakness of the cervical muscle tissue.
The main principle for diagnosing the symptoms of myopathy is the exact differentiation of the case with the identification of the provoked factor. The patient is sent to EMG. With myopathic syndrome, specific deviations in the results of the study are noticeable. A therapeutic course aimed at eliminating thyrotoxicosis allows you to exclude the considered complex of symptoms if the patient's condition is not too serious. In rare cases, myopathy worries against hypothyroidism.
Hormones and muscle condition
Secondary myopathic syndromes can develop against the background of Itsenko-Cushing's disease. This is a neoplasm in the adrenal glands or pathological proliferation of organ tissues, initiating an excessive release of hormonal compounds into the circulatory system. Hypercorticism may indicate a disease. Similar manifestations are observed if the patient uses corticosteroids for a long time. In the patient’s map, steroid myopathy is recorded.
If a person has undergone surgery on the organs of the reproductive system, there is a probability of insufficient functioning of the glands, a lack of a number of hormonal compounds in the body. Similar effects are possible with menopause, X-ray castration. In neurology, this type of myopathic syndrome is called muscle pathology with myopathy as a symptom. If the cause is menopause, Nevinovsky myopathy is diagnosed. Its characteristic features are proximal paresis, muscle atrophy, worsening of tendon reflexes. The optimal therapeutic course is the intake of androgens. Most patients achieve either significant progression of the condition, or the complete elimination of the disease.
Myopathic syndrome is sometimes observed with somatic diseases associated with the work of the hypothalamus. Improper functioning of this brain can be triggered by infectious invasion, trauma. Problems in the hypothalamus work affect muscle tone, and the manifestations of myopathy are aggravated by other disorders of the muscular and nervous systems. Myasthenia gravis is possible, some have myoplegic symptoms.
Skin pathologies and myopathy
Sometimes myopathic syndrome is observed against the background of poly-, dermatomyositis. These pathological processes may be accompanied by paresis, atrophy. The picture of the course is close to true myopathy. For the correct diagnosis and differentiation of the case, it is necessary to assess the presence of a pain syndrome that is not characteristic of myopathy. In addition, the pathological condition in question develops rather quickly. With a careful examination of the patient's condition, it is possible to detect other signs and manifestations that are not associated with myopathy, but indicate the initial pathology.
In the case of polymyositis, the general symptomatology is expressed by a moderate level of manifestation. To clarify the diagnosis, a biopsy should be prescribed. If myopathy is suspected, a feature of differential diagnosis is the focus on the response of the patient to various drugs. If the cause of the syndrome is polymyositis, the use of corticosteroid medications allows you to achieve a pronounced effect in the shortest possible time.
Malignant processes
Sometimes myopathic syndrome and muscular dystrophy are observed with sarcoidosis. The cause of the pathological condition is granulomatous neoplasms localized in the patient's muscles. A distinctive feature of the underlying disease is the proliferation of lymph nodes on the periphery of this system, the increase in lymph nodes in the mediastinum. The patient suffers from fever. The proximal muscle sections weaken, the examination establishes atrophy. Similar processes occur in the muscles of the pelvis, shoulder, and sometimes in the facial tissues of the body.
The described clinical picture of the myopathic syndrome is accompanied by specific tissue changes detected during histological examination. Muscle biopsies are obtained for analysis. In laboratory conditions, it is possible to detect an infiltrate formed by lymph and histiocytes, blood serum cells. By structure, granulomas are similar to those formed during tuberculosis, but they are not characterized by caseous decomposition. Dystrophic processes are localized in muscle tissue. To alleviate the condition of the patient, corticosteroid therapy is indicated.
Trichinosis causes
Myopathic syndrome may be accompanied by muscle pain, a tendency to swelling. Most often, swelling is noticeable on the face, primarily on the eyelids. Possible low-grade fever or fever. As a rule, the localization of the syndrome is ocular, deltoid muscles, buttocks and calves, gaps between the ribs.
If there is a suspicion of trichinosis, endocrine, dysmetabolic myopathic syndrome PDE - to assess lesions of muscle tissue, as well as histological examination. For him, samples of muscle biopsy samples are obtained. Laboratory studies can identify inflammatory mediators, detect Trichinella (a type of parasite). For the final confirmation of the diagnosis, antibodies are used to conduct an intradermal test.
Secondary myopathy
Such a myopathic syndrome is possible in which changes in the structure and functionality of the muscles appear due to some primary pathology. Quite often, secondary myopathy is localized in the heart - we will consider this option further. Typical symptoms of the phenomenon are soreness in the chest, increased breathing, failure of the speed and frequency of the heart rate, general weakness. To clarify secondary myopathy, the patient is sent for an ECG, echocardiography, chest x-ray, blood samples are taken to study the biochemical composition. Pathogenetic therapeutic course - control of metabolism in the heart muscle. To eliminate the symptoms, prescribe drugs that correct the conductivity and rhythm of heart contractions, eliminating the failure of the functioning of the body.
There are many reasons for this. Many cases of secondary myopathic syndrome are known due to alcohol abuse, uremia, as well as a disease provoked by drugs, ethylene glycol, derivatives of heavy metals. Infectious factors are also fairly common causes. Myopathic syndrome can occur against typhoid, viral invasion, and some other diseases. There is a likelihood of such a pathology due to diabetes, thyrotoxicosis, gout, lack of vitamins in the body or imbalance in electrolytes. In some cases, secondary myopathy is explained by the incorrect functioning of the digestive system, cirrhosis, and malabsorption syndrome.
Case Nuances
Secondary myopathy occurs with a uniform spreading lesion of myocardial tissue. The start of the process is the malfunctioning of enzyme systems that regulate metabolic processes at the cellular level. Failures in metabolism make myofibrils inoperative, myocardium loses the ability to actively contract. Tests show metabolic instability of the heart muscle.
Categories and types
There are alcoholic, toxic, medicinal, metabolic forms of secondary myopathic syndrome, as well as a form of pathology associated with the work of the gastrointestinal tract, connective tissue diseases, nervous and muscle disorders. Secondary myopathy is possible against the background of dyslipidosis, mucopolysaccharidosis, invasion of parasites, bacteria, viruses. Infiltration of heart muscle tissue is sometimes observed with carcinomatosis, leukemia.
How to notice?
Myopathic syndrome is accompanied by myocardial inability to contract normally. In the chest, the patient feels aching pain, aggravated by physical exertion. The nature is not similar to ischemia, it is not peculiar to spread to other tissues and organs. Gradually, the pain subsides itself - no special medications are needed. Then the condition worsens, shortness of breath becomes stronger, swelling disturbs, the patient feels weak and lethargic. Dizzy, arrhythmia and tachycardia develop.
What to do?
Secondary myopathic syndrome is a polyetiological pathological condition characterized by a wide variety of manifestations. To manage the case, a commission of doctors of different specialties is collected. The treatment is chosen in such a way as to normalize metabolic processes, optimize cardiac output and prevent degradation of the heart muscle.
The patient will have to give up smoking and alcohol, significant physical exertion, review the diet. If the manifestations are very pronounced, a medical course is chosen to weaken them, cardiac glycosides, vitamin therapy, and myocardial metabolism activators are prescribed.
Children get sick: a special case
In childhood, myopathic syndrome is not so common, but myotonic is quite common. It is also a neuromuscular pathology that brings a lot of anxiety to both the child and his parents. Not all doctors recognize the allocation of the syndrome as a consistent disease, since the term includes various disorders in the functioning of the muscles. The description of myotonic syndrome in children in different sources is quite different. Some urge by this term to understand myotonia that appeared from birth, others diagnose as a pathology all cases of problems with fiber relaxation, including temporary disorders. It is generally accepted that a congenital disease is a classic form of the syndrome.
Where did the problem come from?
So far, it has not been possible to identify why myotonic syndrome develops in children. Presumably, the propensity to it is inherited, the metabolic failure in the maternal organism plays a role, if any, occurred during gestation. Myotonia can be caused by drugs that were used by the expectant mother during pregnancy.
Acquired myotonic syndrome can form if the child is inactive, has been ill with rickets, suffers from metabolic failures. Different forms of the pathological condition are observed with tetanus and antipsychotic syndrome. Schwarz-Jampel disease, encephalomyelitis, or elevated body temperature can manifest themselves in symptoms similar to myopathy. Similar risks are associated with the so-called “rigid person” condition. Similar symptoms appear after a bite of a Black Widow spider.
How to recognize?
Myotonic syndrome manifests itself as specific deviations in movements: after a contractile act, muscle tissue does not relax, as is normal. Instead, tonic tension arises. It is difficult for the patient to take the first step after a prolonged state of rest, and after several cycles of relaxation and activation, the process is simpler. As a rule, the stage of muscle relaxation requires about half a minute.
With a congenital form, it is not easy to immediately notice myotonic syndrome. Its symptoms are most obvious if the child is active, trying to make quick movements that require complex coordination. With congenital myotonia, the baby learns to walk and talk later than peers. These children have problems with posture.
How to help?
The treatment of myotonic syndrome in children is mainly palliative, they select a course of drugs and procedures to improve the general condition of the body. Medicine does not yet know the ways of absolute cure. The symptomatic course allows the patient to lead a normal, adequate life. If the attacks are intense, drugs are prescribed to reduce the likelihood of manifestations.
If the child is sick with myotonic syndrome, parents will have to immediately learn a special massage - such procedures are considered the most effective in a therapeutic course. It should protect the child from stress, increased physical activity, being in the cold. It is contraindicated to spend a long time in a relaxed position. Muscle syndrome sufferers should be strengthened. Recommended hardening, daily walks, a strictly healthy lifestyle. The effect can be fixed with physiotherapeutic procedures, swimming.