Does Muscular Dystrophy Get Worse Over Time?
Yes, muscular dystrophy (MD) progresses and get worse over time, the rate of progression depends on the type of muscular dystrophy.1 There are about 30 different types of muscular dystrophy, the age that the symptoms develop; disease progression is different in each type. In this article, I will be talking about the disease progression of some common types of muscular dystrophy.
Duchenne Muscular Dystrophy
Duchenne muscular dystrophy (DMD) usually occurs in males aged 3-5 years. Initially it affects the thighs and hips, DMD progress rapidly with time they have difficulty in standing up, maintaining balance, walking and climbing stairs. By the age of 12 years most children are wheelchair bounded as they have difficulty in walking. With time the muscles in the shoulders and upper limbs also get affected, they find it hard to raise their arms. DMD also affect the respiratory and heart muscles usually after the age of 15 years therefore, regular heart-respiratory monitoring and ventilator support and drugs are needed. Most of them die of cardio-respiratory failure in late 20’s or early 30’s. This is the typical picture of DMD, however the disease progression rate depends on the individual patient and new treatment modalities have been able to prolong the life span more.
Becker Muscular Dystrophy
Becker muscular dystrophy (BMD) is also quite similar to DMD, but it tends to develop later in life. BMD typically develops in males aging 11-15 years. It affects the muscles of the thigh, hips, pelvic area and shoulders. The disease progression is much slower and unpredictable than DMD. Some BMD patients might be wheelchair bounded by the age of 20, some by the late 30’s and some may never get any walking difficulties. They live usually until 40 years or more and the cause of death in BMD is cardio-respiratory failure.
Myotonic Dystrophy
Myotonic dystrophy (DM) is the most common adult muscular dystrophy type.2 It usually affects both males and females, usually occurs between the ages of 20-30 years. Progression of DM is slower, but it can vary among individuals. It can affect the muscles of the heart and cause death at around 30-40 years. There are two types DM1 and DM2, DM1 is the most common type. DM1 adult-onset type which is the common one, starts in young adulthood, it initially affects the muscles of the face, neck, hands and ankles. The weakness progresses to other muscle groups with time. DM2 affects the proximal muscles like the hip, pelvic; therefore, they can have walking difficulties with time. However DM2 has a slower progression compared to DM1.
Congenital Muscular Dystrophy
Congenital muscular dystrophy (CMD) is usually present at birth or before 2 years of age, it occurs in both males and females.3 It usually affects most of the muscles in the body along with joint stiffness. There are many types of CMD and the symptoms are according to type of CMD. According to the type there can be loss of motor functions, joint stiffness, scoliosis, swallowing problems and breathing difficulties. The progression is slow, some live only till infancy whereas some live up to adulthood with minimum disabilities.
Emery-Dreifuss muscular dystrophy
Emery-Dreifuss muscular dystrophy (EDMD) typically occurs in males’ age 10 years, but can develop even at 20 years. Muscle weakness usually initiates in the upper arms and legs, it is followed by weakness in the shoulders and hips. Progression of weakness is slow during childhood and early adulthood, but it tends to progress rapidly when EDMS develop in adulthood. However they never get problems with walking. Heart problems can occur from the age of 10-19 years and they can die of complications from heart problems.
Summary
Yes, muscular dystrophy (MD) progress and get worse over time, the rate of progression depends on the type of muscular dystrophy. Duchenne muscular dystrophy progress rapidly with time they have difficulty in standing up, maintaining balance, walking and climbing stairs. By the age of 12 years most children are wheelchair bounded as they have difficulty in walking. Becker muscular dystrophy the disease progression is much slower and unpredictable than DMD. Myotonic dystrophy progression is slower, but it can vary among individuals. Congenital muscular dystrophy and Emery-Dreifuss muscular dystrophy has a slower progression.
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