Muscle atrophy

Atrophy of muscle is a process that develops into muscle and leading to a progressive reduction in their volume and rebirth. Muscle fibers gradually become thinner, in severe cases, their number is dramatically reduced, sometimes they completely disappear. There are primary, or simple, and the secondary or neurogenic muscle atrophy.
muscle atrophyPrimary muscular atrophy depends on the defeat of the muscles. In its basis lies hereditary disorder of metabolism in the form of a congenital defect muscle enzymes or increase the permeability of the muscle membrane. However, a significant role is played and environmental factors contributing to the development of the disease (physical stress, infection, trauma). Most clearly the primary muscular atrophy expressed in myo (see).
Secondary, or neurogenic muscle atrophy is developing at defeat of the cells of the front horns spinal cord, roots or peripheral nerves. In the latter case, atrophic syndrome accompanied by frustration of sensitivity. Secondary muscular atrophy develops after injury nerve trunks, when infections involving the musculoskeletal cells of the anterior horns of the spinal cord (polio and polimaltosny disease). In some cases the process is hereditary. This is typical mainly of the distal location atrophy (muscle feet, legs, hands and forearms) with a slower, more benign course of the process. There are several forms of neurogenic atrophy:
When neural disease, or disease, Charcot - Marie, affects the muscles of the feet and lower legs (Fig.), especially the group extensor and outlet foot muscles. Feet deformed. Gait acquires the character of the so-called steppage: patients with walking highly raise your knees so that overhanging feet not clung to the floor. Reflexes fade, reduced surface sensitivity in the distal extremities. A few years after the onset of the disease atrophy apply to the hand and forearm.
Progressive muscular atrophy, werdnig - Hofmann occurs most difficult. The disease usually begins in early age, often have several children in the family outwardly healthy parents. Atrophy accompanied by loss of tendon reflexes, severe hypotension and fibrillar twitching.
Atrophic syndrome is observed in progressive muscle atrophy adult - atrophy of Haran - DuChene. First, the process is localized in the distal upper limb. Atrophy of the exaltation of the thumb and the little finger and interosseous muscle. Formed very characteristic posture hands in the form of a monkey brush". Disappear tendon reflexes, sensitivity is maintained. The process progresses steadily, spreading the muscles of the neck and trunk.
Treatment. In the treatment of muscle atrophy apply: disodium salt adenosine triphosphate 1% solution for 1 to 2 ml intramuscularly at the rate of 30 injections; vitamin B1 0.5-1 ml of 5% solution intramuscularly; vitamin B12 0,5-1 ml of 0.01 % solution of a day intramuscularly at the rate of 15 to 20 injections; vitamin E 1 teaspoonful 1-2 times a day; galantamine 0.25% solution 0.3 - 1 ml subcutaneously every day, the course of 10-15 injection; inside Dibazol or oksazil the rate of 0.001 g on 1 the year of a child's life 1 time per day; neostigmine 0.001 g on 1 year of a child's life 1 per day (adults) - 0.015 g 2-3 times a day) orally or subcutaneously 0.05% solution 0.3 - 1 ml depending on the age, every other day, 10-15 injection. Applied also transfusion single-group of blood (150-200 ml), electrotherapy and massage. This treatment is pursued separate courses within months, brings every time some improvement, and sometimes can contribute to the stabilization process.

Atrophy of muscle is a pathological process that develops into muscle leading to reduction in their volume and rebirth. An early sign of the development of atrophic process in the muscle is the homogenization of the muscle fibers and education vacuoles in breach of the colloid structure and changes in the water exchange of the muscle tissue. As the progression of the process, the number of muscle fibers in the muscle decreases and their contractile part can to be replaced with connective and adipose tissue, forming pseudohypertrophy. In the final stage in the number of muscle develops sclerotic process leading to the development of retraktsii and contractures.
There are two types of muscle atrophy: the primary or simple, and the secondary or neurogenic.
Primary, or simple, muscular atrophy caused by defeat of the muscles and develop while maintaining the structure and function of the peripheral motor neuron. It is characterized by quantitative changes of elektrovozoremontnij, lack of fibrillar twitching. Mechanical excitability of muscles maintained. In this form often retraction.
The etiology and pathogenesis of simple muscular atrophy is still not resolved. Is based on, apparently, disorders of metabolism. Known already some enzymatic defects of the currency, leading to muscular dystrophy. The factors leading to the development of the disease, diverse: malnutrition, trauma, monotonous voltage certain muscle groups at work, long-term current infection, many chronic intoxication. It is known development A. M. in cases of hypothyroidism, after thyroidectomy and other thyroid dysfunction, and when the pituitary disorders, cachexia of Simmonds, Addison disease, and other endocrine disorders. A. M. may develop as a result of prolonged immobilization limbs after applying gypsum fractures, orthopedic operations, as well as long inactivity sick extremity, when hemiplegia and monoplegia Central origin. Undoubtedly are important and severe mental strain, resulting in the dynamical breakdown of the higher nervous activity to somatic disorders.
In the pathogenesis of muscle atrophy should also account for violations of the sympathetic innervation associated with dysfunction of the Central and peripheral structures of the autonomic nervous system that also affect the changes of metabolic muscle tissue. This is also evidenced by A. M. reflex of origin, developing after the operation on the cervical sympathetic nerve or after cervical sympathectomy, also as a result of long painful irritation with bruises, broken bones, for painful scars and inflammatory processes that cause pathological centripetal impulsaciu. In these cases, along with the violation of the trophic muscles develop and other vegetative and animal symptoms - hypoesthesia, hyperreflexia, cyanosis and cooling of the extremities, sweating, osteoporosis, etc. it is also Known that at loss of the sympathetic innervation suffers first proximal muscles, richer sympathetic fibers.
In the group of plain muscular atrophy includes the so-called arthritic (the latter) A. M., developing diseases of the joints. However muscles atrophy, lying near the affected joint (for example, interosseous - for diseases of the joints of the hand, deltoid - diseases of the shoulder joint and others) (see Myopathy).