How To Diagnose Charcot Marie Tooth & What Is The Best Medicine For It?

As a neurological disease, Charcot Marie Tooth (CMT) can be a hereditary problem. It affects the nerves that control your voluntary muscle movements. It can cause weak legs, difficulty standing and walking, and foot problems. It can also complicate the movement of fingers, hands, wrists, and tongue. Physiotherapy is widely used to treat Charcot Marie Tooth. Your doctor may also prescribe orthopedic devices such as splints or braces.

Charcot Marie Tooth was named after the doctors who discovered it in 1886: Jean-Martin Charcot, Pierre Marie, and Henry Tooth. This condition is sometimes called hereditary motor and sensory neuropathy or personal muscle atrophy.1

How To Diagnose Charcot Marie Tooth?

Diagnosis is done primarily by clinical observation of the patient, walking behavior and examination of the feet, legs, hands, muscle volume, and nerve sensitivity. An examination called electromyogram and nerve biopsy will further strengthen the diagnosis.

  • A doctor will ask for family history and will look for evidence of muscle weakness, reduced muscle tone, flat feet or high-arched feet.
  • If there is a chance that the patient may have Charcot Marie Tooth, they must see a neurologist for further testing.
  • Nerve conduction studies measure the strength and speed of electrical signals passing through the nerves. Electrodes are placed on the skin, and these deliver tiny electric shocks that stimulate the nerves. A delayed or weak response indicates a disorder of the nerves and possibly Charcot Marie Tooth.
  • Electromyography (EMG) involves inserting a thin needle into the targeted muscle. When the patient relaxes or tightens the muscle, electrical activity is measured. The examination of different muscles shows which are affected.
  • A biopsy will take a small piece of peripheral nerve out of the calf for testing in a lab.
  • The genetic examination is carried out by a blood sample. This can show if the patient has a faulty gene or genes.2,3

What Is The Best Medicine For Charcot Marie Tooth?

Although research in this area is very active, there is currently no cure for Charcot Marie Tooth disease. Only care to delay its development or effects on a daily basis is achieved. Although there is no cure for Charcot Marie Tooth, treatment can relieve symptoms and delay the onset of physical disabilities.

These include physiotherapy, which is often essential, as well as the use of braces, orthopedic shoes or the use of a cane. Orthopedic surgery can in some cases bring relief and maintain the state of the feet. The use of a wheelchair is often necessary.

  • NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, can help reduce joint and muscle pain, as well as pain caused by damaged nerves.
  • Tricyclic antidepressants (TCAs) may be prescribed if NSAIDs are not effective. TCAs are commonly used to treat depression, but they can relieve neuropathic pain symptoms. However, they can have side effects.
  • Physical therapy uses low-impact exercises to help strengthen and stretch the muscles. This can help to maintain muscle strength and prevent muscle tightening.
  • Occupational therapy can help patients who have problems with finger movements and gripping, as this can make it very difficult to perform daily activities.
  • Devices such as orthopedic devices, braces or splints can help individuals stay mobile and prevent injury. Shoes with high-heel or special boots provide extra ankle support, and special shoes or shoe inserts can improve steps.
  • Patients who also have scoliosis or curvature of the spine may need a posterior brace and sometimes surgery.
  • Surgery to merge bones in the feet or to remove part of a tendon can sometimes relieve pain and facilitate walking. Surgery will help in correcting flat feet issues and deformities of the heel, and also help ease the joint pains.4,5

Conclusion

Physiotherapy is a common treatment for people with Charcot Marie Tooth. It includes many routes and easy exercises. This therapy helps to increase your muscle strength and prevent atrophy or muscle breakdown. If you lose the function in your extremities, you may be provided with tools that you can use to grab, reach, and push objects. Thumb rails are also available for people who have difficulty grasping items. You can also get orthopedic devices such as splints to help prevent weak leg injuries and increase stability. If you have a severe foot deformity, it may be treated by a combination of orthotic (specialty) shoes and surgical corrective measures.

References:  

  1. Khadilkar SV, Yadav RS, Patel BA. Charcot–Marie–Tooth Disease. Neuromuscular Disorders: Springer; 2018:421-439.
  2. Pfeiffer G, Wicklein E, Ratusinski T, Schmitt L, Kunze K. Disability and quality of life in Charcot-Marie-Tooth disease type 1. Journal of Neurology, Neurosurgery & Psychiatry. 2001;70(4):548-550.
  3. Barreto LCLS, Oliveira FS, Nunes PS, et al. Epidemiologic study of Charcot-Marie-Tooth disease: a systematic review. Neuroepidemiology. 2016;46(3):157-165.
  4. Young P, De Jonghe P, Stögbauer F, Butterfass‐Bahloul T. Treatment for Charcot‐Marie‐tooth disease. Cochrane database of systematic reviews. 2008(1).
  5. McCorquodale D, Pucillo EM, Johnson NE. Management of Charcot–Marie–Tooth disease: improving long-term care with a multidisciplinary approach. Journal of multidisciplinary healthcare. 2016;9:7.

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