Wenninger Stephan, Montagnese Federica, Schoser Benedikt
Friedrich-Baur-Institute, Klinikum der Universität München, Munich, Germany.
Front Neurol. 2018 May 2;9:303. doi: 10.3389/fneur.2018.00303. eCollection 2018.
Myotonic dystrophy type 1 (DM1) and type 2 (DM2) represent the most frequent multisystemic muscular dystrophies in adulthood. They are progressive, autosomal dominant diseases caused by an abnormal expansion of an unstable nucleotide repeat located in the non-coding region of their respective genes DMPK for DM1 and CNBP in DM2. Clinically, these multisystemic disorders are characterized by a high variability of muscular and extramuscular symptoms, often causing a delay in diagnosis. For both subtypes, many symptoms overlap, but some differences allow their clinical distinction. This article highlights the clinical core features of myotonic dystrophies, thus facilitating their early recognition and diagnosis. Particular attention will be given to signs and symptoms of muscular involvement, to issues related to respiratory impairment, and to the multiorgan involvement. This article is part of a Special Issue entitled "Beyond Borders: Myotonic Dystrophies-A European Perception."
1型强直性肌营养不良(DM1)和2型强直性肌营养不良(DM2)是成年期最常见的多系统肌肉营养不良症。它们是由位于各自基因非编码区的不稳定核苷酸重复序列异常扩增引起的进行性常染色体显性疾病,DM1的相关基因是DMPK,DM2的相关基因是CNBP。临床上,这些多系统疾病的特点是肌肉和肌肉外症状高度变异,常导致诊断延迟。对于这两种亚型,许多症状重叠,但一些差异有助于临床区分。本文重点介绍强直性肌营养不良的临床核心特征,从而便于早期识别和诊断。将特别关注肌肉受累的体征和症状、与呼吸功能损害相关的问题以及多器官受累情况。本文是名为“超越国界:强直性肌营养不良——欧洲视角”的特刊的一部分。