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A 2-Year-Old Girl with Hypotonia Since Birth and Delayed Motor and Speech Development

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A Case-Based Guide to Neuromuscular Pathology

Abstract

Merosin deficient congenital muscular dystrophy is one of the most common forms of congenital muscular dystrophy. Merosin, also known as laminin α2, is encoded by the LAMA2 gene. It is present in the basal lamina of skeletal muscle and Schwann cells. There is a wide clinical spectrum of the disease with patients usually presenting at birth with hypotonia and weakness accompanied by respiratory and feeding difficulties. Ophthalmoparesis particularly in upper gaze is common. Serum creatine kinase (CK) level can be elevated up to 10 times the normal value. Brain MRI shows increased T2 signal in white matter, which is thought to be from abnormal myelination. Since laminin α2 is present in the basement membranes of Schwann cells, some patients develop peripheral neuropathy. Muscle pathology is characterized by a complete or partial deficiency of laminin-α2 with dystrophic changes.

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References

  1. Clement EM, Feng L, Mein R, Sewry CA, Robb SA, Manzur AY, et al. Relative frequency of congenital muscular dystrophy subtypes: analysis of the UK diagnostic service 2001–2008. Neuromuscul Disord. 2012;22(6):522–7.

    Article  CAS  Google Scholar 

  2. Gilbreath HR, Castro D, Iannaccone ST. Congenital myopathies and muscular dystrophies. Neurol Clin. 2014;32(3):689–703, viii

    Article  Google Scholar 

  3. Geranmayeh F, Clement E, Feng LH, Sewry C, Pagan J, Mein R, et al. Genotype-phenotype correlation in a large population of muscular dystrophy patients with LAMA2 mutations. Neuromuscul Disord. 2010;20(4):241–50.

    Article  Google Scholar 

  4. Sunada Y, Edgar TS, Lotz BP, Rust RS, Campbell KP. Merosin-negative congenital muscular dystrophy associated with extensive brain abnormalities. Neurology. 1995;45(11):2084–9.

    Article  CAS  Google Scholar 

  5. Iannaccone ST, Castro D. Congenital muscular dystrophies and congenital myopathies. Continuum (Minneap Minn). 2013;19(6 Muscle Disease):1509–34.

    Google Scholar 

  6. Durbeej M. Laminin-alpha2 chain-deficient congenital muscular dystrophy: pathophysiology and development of treatment. Curr Top Membr. 2015;76:31–60.

    Article  Google Scholar 

  7. Dubowitz V, Sewry CA, Lane RJM. Muscle biopsy: a practical approach. 3rd ed. Great Britain: Saunders Elsevier; 2007. xiii, 611 p.

    Chapter  Google Scholar 

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Correspondence to Diana P. Castro .

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Castro, D.P., Cai, C., Jacob Paul, D. (2020). A 2-Year-Old Girl with Hypotonia Since Birth and Delayed Motor and Speech Development. In: Zhou, L., Burns, D., Cai, C. (eds) A Case-Based Guide to Neuromuscular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-25682-1_25

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  • DOI: https://doi.org/10.1007/978-3-030-25682-1_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25681-4

  • Online ISBN: 978-3-030-25682-1

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