muscle atrophy
Introduction
Introduction to muscle atrophy Muscle atrophy refers to the reduction of muscle volume caused by dystrophic dystrophy, muscle fiber thinning or even disappearance. The main causes are: neurogenic muscle atrophy, myogenic muscle atrophy, disuse muscle atrophy and other causes of muscular atrophy. In addition to the pathological changes of muscle tissue itself, muscle nutrition is closely related to the nervous system. Spinal cord disease often leads to muscular dystrophy and muscle atrophy. Patients with muscular atrophy stay in bed for a long time due to muscle atrophy and muscle weakness, and are prone to pneumonia, hemorrhoids, etc. In addition, most patients have symptoms of bulbar palsy, posing a great threat to the patient's life. In addition to doctors for treatment of muscle atrophy, self-regulation is very important. basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: muscular dystrophy Myasthenia gravis syndrome
Cause
Cause of muscle atrophy
Genetic (10%):
Genetic factors, 5%-10% of patients with hereditary, commonly referred to as familial amyotrophic lateral sclerosis, adult type autosomal dominant inheritance, young type autosomal dominant or recessive inheritance, It is difficult to distinguish clinically from sporadic cases.
Long-term non-exercise (25%):
Disuse muscle atrophy The motor neuron lesions are caused by long-term inactivity of the muscles, systemic wasting diseases such as hyperthyroidism, malignant tumors, autoimmune diseases, and the like.
Poisoning (15%):
Poisoning factors, excitatory toxic neurotransmitters. After investigation, the loss of transport function in some patients was caused by abnormal connection of the transcriptional copy of the transporter mRNA in the motor cortex.
Immunization (15%):
Immune factors, although multiple antibodies and immune complexes have been detected in the serum of MND patients, there is no evidence that these antibodies can selectively target motor neurons as motor neurons. It is now believed that MND is not an autoimmune disease of the nervous system.
Disease factors (20%):
Myogenic muscle atrophy is common in muscular dystrophy, dystrophic myotonia, periodic paralysis, polymyositis, trauma such as crush syndrome, ischemic myopathy, metabolic myopathy, endocrine myopathy , drug-induced myopathy, neuromuscular transmission disorders such as myasthenia gravis.
Prevention
Muscle atrophy prevention
1. Maintain an optimistic and happy mood.
2. Rationally adjust the diet structure.
3, work and rest.
4, strict prevention of colds, gastroenteritis
5, physical therapy, increase muscle strength exercise, walking training, warm bath, massage, acupuncture.
6, the application of B vitamins, and B1, B6, B12 combined application.
7, Chinese medicine treatment: the use of ginseng, Astragalus, whole insects, turtle shell, angelica and other Chinese herbal medicine.
Complication
Muscle atrophy complications Complications muscular dystrophy myasthenia gravis syndrome
Can cause muscular dystrophy, myasthenia gravis-like syndrome.
Symptom
Muscle Atrophy Symptoms Common Symptoms Thigh Muscle Atrophy Interosseous Muscle and Fish Muscle Atrophy Scapular Band Muscle Atrophy Hand Muscle Atrophy Myasthenia Gravity Calf Muscle Atrophy Facial Muscle Atrophy Muscle Pain Hip Muscle Injury Arm Muscle Strain
Thigh muscle atrophy: thigh muscle atrophy in patients with femoral head necrosis is a common phenomenon, the weight of muscle atrophy is different, most patients with femoral head necrosis can recover from thigh muscle atrophy, but a few femoral head necrosis patients can not lose their thigh muscles for life. Recovery, seriously affecting the walking distance of patients and the quality of life of patients. 100% of patients with advanced femoral head necrosis have varying degrees of thigh muscle atrophy in the affected limbs. The impact on the walking of patients with femoral head necrosis is very large, which directly limits the recovery of the thigh of the affected limb and limits the length of walking of the patient.
Calf muscle atrophy: refers to calf muscle atrophy refers to striated muscle malnutrition, muscle volume is smaller than normal, muscle fibers become thinner or even disappear.
Muscle atrophy: a type of muscle atrophy.
Muscle atrophy refers to the reduction of muscle volume caused by dystrophic dystrophy, muscle fiber thinning or even disappearance.
1. Mild atrophy: The muscle fiber is slightly decreased, the appearance of muscle tissue is not obviously depressed, the muscle tissue is loosened, the muscle is weak, and resistance exercise can be performed.
2. Moderate muscle atrophy: partial atrophy and loss of muscle fibers, faint appearance of muscle tissue, narrowing of the longitudinal direction of the touch, lateral reduction, obvious muscle weakness, and resistance to movement.
3. Severe muscle atrophy: Most of the muscle fiber tissue shrinks and the associated bones are exposed. There is only a small amount of muscle fiber in the muscle tissue, the muscle weakness is severe, and the patient loses the most basic coordination exercise ability.
4. Complete atrophy: The muscle fiber tissue is completely atrophied and the motor function associated with its muscle is completely lost.
Scapular muscle atrophy: the symptoms and clinical manifestations of progressive proximal extremity muscle atrophy. Progressive extremity proximal muscular atrophy is often myogenic atrophy, with proximal and trunk muscles of the extremities, often showing atrophy and weakness of the scapular and pelvic girdle muscles. If the neck muscles are weak, some patients need to support them by hand to lift the head. The muscle atrophy of the shoulder blades constitutes a winged shoulder blade.
Myogenic pancreatic muscle atrophy: is caused by muscle disease itself, and may also include other factors, such as shoulder or facial scapular type of muscular dystrophy, confirmed by morphological examination of spinal muscular atrophy. On the other hand, when any part of the motor neurons is damaged, the acetylcholine released from the distal part is reduced, and the sympathetic nutrient effect is weakened, resulting in muscle atrophy.
Interosseous muscle and intermuscular muscle atrophy: usually with small hand muscle weakness and progressive muscle atrophy, which can affect one side or both sides, or from one side to the opposite side. Due to the atrophy of the size of the fish muscles, the palms are flat, and the interosseous muscles are atrophied and have claw-like hands. Muscle atrophy is extended upwards, gradually invading the forearm, upper arm and shoulder strap. Muscle twitching is common and can be limited to certain muscle groups or widespread, and it is easier to induce by hand tapping. A small number of amyotrophic muscle weakness can be initiated from the tibialis anterior and tibialis musculature of the lower extremities or from the extensors of the neck, and individually from the proximal muscles of the upper and lower extremities.
Examine
Muscle atrophy check
First, the electromyogram (EMG)
Second, nerve conduction velocity (NCV), including motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV), F wave, H reflection
3. Evoked potentials (EP), including brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP), and upper and lower extremity somatosensory induction (SEP)
Fourth, event-related potential (P300) Their main application range
(1) Electromyography: As a means of measuring the function of the motor system, it has been widely used to distinguish between weak muscle strength and muscle atrophy, caused by myopathy, or caused by neuropathy, or other causes. Through the needle electromyography, the measurement of muscles in different parts of the body can be understood: (1) whether the muscle lesion belongs to neurogenic damage or myogenic damage; (2) the site of neurogenic damage (anterior horn cells or nerve roots, nerves) (3) whether the lesion is active or chronic; (4) the ability of nerve regeneration; (5) to provide a basis for diagnosis and differential diagnosis of myotonia and its classification. It can be used as a monitoring method for unexplained muscle atrophy, numbness, weakness, physical activity disorder and other diseases. It can also be used as a monitoring method after or after treatment of nerve injury, as well as an objective indicator for rehabilitation, disability and forensic identification.
(B) nerve conduction velocity: is a diagnostic technique to assess the peripheral motor nerve and sensory nerve conduction function. Mainly used for the diagnosis of peripheral neuropathy such as polyneuropathy, hereditary peripheral neuropathy, Guillain-Barré syndrome, carpal tunnel syndrome, peripheral nerve trauma, etc., combined with electromyography to identify anterior horn cells, nerve roots, peripheral nerves and Myogenic diseases, etc.
(3) Visual evoked potentials: It mainly detects lesions in visual pathways and is widely used in ophthalmology for optic neuritis, retrobulbar neuritis, optic atrophy, optic nerve compression lesions, multiple sclerosis, visual cortical lesions, ocular trauma, rickets and other diseases. The internal medicine is mainly used for the lesions of the visual pathway caused by diabetes, which plays an important role in early diagnosis, localization diagnosis, estimation of prognosis, and evaluation of curative effect.
(4) Brainstem auditory evoked electricity: main examination of auditory nerve injury, paroxysmal vertigo, acoustic neuroma, multiple nerve sclerosis, auricular sputum and audiological examination after peripheral injury; objective evaluation of auditory uncooperative, infant and hysterical patients There is no hearing dysfunction.
(5) Somatosensory evoked potentials: mainly used to detect the functional status of peripheral nerves, nerve roots, spinal cord, brain stem, thalamus and brain. Applied to Guillain-Barré syndrome, cervical spondylosis, posterior lateral sclerosis syndrome, multiple sclerosis, cerebrovascular disease, neurogenic bladder, sexual dysfunction, etc.
(6) Event-related potentials: clinically used for diagnosis and efficacy judgment of dementia, brain injury, chronic encephalopathy such as hepatic encephalopathy, mental illness, and evaluation of brain development in children.
Diagnosis
Diagnosis of muscle atrophy
For the diagnosis of muscle atrophy, we can do it in the following ways.
First, medical history
For muscle atrophy, attention should be paid to the age, the location of the disease, the onset of disease, the length of the disease, etc.; acute onset, or chronic onset, is gradually progressing, or rapid development. Whether there is sensory disturbance, urinary dysfunction, atrophy is limited or systemic. The strength of the muscles, the relationship between muscle weakness and muscle atrophy, whether there is muscle beats and pain, is aggravated or reduced after the activity. Past history should pay attention to the presence or absence of systemic diseases such as malignant tumors and connective tissue diseases.
Second, physical examination
1. Pay attention to muscle volume and appearance: The diagnosis of muscle atrophy in clinical should be compared on both sides, that is, the distribution of muscle atrophy, the degree, the comparison of bilateral symmetrical parts, and the presence or absence of fasciculation.
2, muscle strength and muscle tension: muscle atrophy is accompanied by low muscle strength, so should pay attention to the comparison of muscle volume and muscle strength, pay attention to the muscle strength of muscle atrophy, muscle tension. The inspection should be carried out in a warm environment and in a comfortable position. Patients should be allowed to relax as much as possible. It can be judged by touching the hardness of the muscle and the resistance that is felt when the patient's limb is flexibly flexed.
