Charcot-Marie-Tooth
(CMT) disease is named after the three neurologists
who first noted the condition around a century
ago. CMT is an inherited neurological disease,
which is characterised by the slow degeneration
of muscles in the lower legs, feet, hand
and forearms.
There are
different types of CMT, each resulting in
varying symptoms and levels of severity.
Type 1, usually referred to as CMT1, affects
the insulating covering surrounding the
nerve fibres, and symptoms are usually first
noticed during late childhood or adolescence.
Type 2, CMT2, affects the nerve fibres themselves
and may start to become noticeable a little
later in life.
CMT is sometimes
called Hereditary Motor and Sensory Neuropathies
(HMSN) or Peroneal Muscular Atrophy (PMA).
Dejerine-Sottas Disease is also very similar
to Charcot-Marie-Tooth disease and is sometimes
referred as CMT3.
Causes
Most commonly,
CMT has an autosomal dominant inheritance
pattern. This means that a child who has one
parent (mother or father) who carries a single
faulty gene, has a 50% chance of inheriting
CMT.
The carrier
does not necessarily show symptoms of CMT.
Less commonly, CMT may be passed on through
an autosomal recessive inheritance pattern.
This means that the child must inherit two
abnormal genes from the parents. Most commonly,
this will mean that both parents carry a
single abnormal gene, but are often not
affected themselves by it. Through this
inheritance pattern the child has a 25%
chance of inheriting and being affected
by CMT, and a 50% chance of becoming a carrier
without any symptoms.
The third
inheritance pattern is called x-linked recessive.
This means that the abnormal gene is carried
on the x chromosome and is passed from mother
to son only. Daughters cannot inherit the
disease in this way but can become carriers
and pass it down to their sons. The son
has a 50% chance of inheriting the disease
from his mother. The daughter has a 50%
chance of becoming a carrier. Often the
mother has no symptoms of the disease at
all.
Very rarely,
CMT can occur spontaneously. In other words,
without any inheritance pattern. This can
only happen with Type 1 CMT. The disease
then becomes autosomal dominant (see beginning
of section)
Treatment
Breathing problems from Phrenic nerve
paralysis, when the nerve that controls
the diaphragm becomes paralysed, can very
rarely occur as a result of CMT1, but this
complication is more common with CMT2. Some
patients with CMT2 have prominent nerve
and vocal paralysis, which results in hoarseness
and shortness of breath.
Some of the
physical problems caused by CMT can be treated
with surgery. For example, surgery is often
carried out on feet to correct problems
with ankles and toes.
People with
CMT who experience pain or discomfort may
be prescribed pain killing drugs or, in
some cases, referred to a specialist pain
clinic. Staff at pain clinics can help people
to develop coping strategies for dealing
with long-term pain as well as helping people
to find the most appropriate drug treatments.
People with
CMT can also benefit from a range of special
aids, equipment and home modifications
depending on how they are affected by the
disease. In some cases, financial assistance
may be available for this through local
council social services departments.
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