Vol 4, No 1 (2014)

Congenital muscular dystrophies (CMD) are a large group of genetically determined muscular diseases, initially defined by an early onset before the age of walking and dystrophic changes on myopathologic analyses. Currently, their definition is less restrictive with, a clinical continuum with limb-girdle muscular dystrophies, and closer histomorphological aspects with congenital myopathies. We distinguish 9 different forms of DMC, classified in 6 different groups depending on the location and/or function of the protein involved, on the control of 26 different genes. Ullrich's disease, UCMD (collagenopathy involving three different genes: COL6A1, COL6A2, COL6A3); secondary dystroglycanopathies (by abnormal glycosylation of alpha-dystroglycan involving 16 different genes); and DMC merosin negative, MDC1A, (merosinopathy secondary to mutations in a unique gene, LAMA2); represent the three most common forms. Rigid spine syndrome type 1, RSMD1 (selenopathy secondary to SEPN1 gene mutation) and L-CMD (laminopathy involving LMNA gene) are also part of the most current forms. Clinical features, plasmatic creatine kinase elevation or not, the presence or absence of clinical signs of central nervous system involvement, allow a first level of diagnostic pathway. According to these elements, muscle and/or cerebral MRI, muscle and/or skin biopsy will be discussed to guide the molecular investigations that will allow accurate diagnosis.

Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease. This pathology is characterized by the involvement of central and peripheral motor neurons in the pathological process. One  f the specific symptoms of ALS is fasciculations - involuntary muscle contractions that may occasionally precede the development of muscle weakness and atrophies. This paper summarizes the accumulated practical experience in using muscle ultrasound study in the diagnosis of fasciculations and their prevalence as an early sign of anterior corneal lesion in ALS.

Lumbago is one of the most common musculoskeletal pain syndromes. The course of lumbago shows a tendency towards frequent relapses and is associated with the significant material costs of medical care. A wide range of analgesics, nonsteroidal anti-inflammatory drugs in particular, whose administration may be linked with an increased risk for adverse visceral reactions, is used to treat patient with lumbago. The risk of their side effects may be reduced by the extensive use of non-drug treatments and the early expansion of a motor regimen in a patient. Therapeutic effectiveness in reducing the likelihood of adverse reactions may be provided by short-term treatment with effective drugs. The advantages of using ketoprofen (ketonal) formulations in patients with lumbago are considered.

The article presents a rare case of a child with a laboratory confirmed combination of several inherited diseases: cystic fibrosis (mutations F508del and E92K) and facioscapulohumeral progressive muscular dystrophy (FSHD). Through the example of the case authors describe the clinical findings of the infantile form of FSHD and the results of prolonged patient’s follow-up. Own clinical data are compared to the literature review. There is also a discussion about genetic heterogeneity of FSHD and complex rehabilitation approaches in case of associated genetic pathology.