Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- história familiar de neuropatia, pés cavos ou marcha irregular
- dificuldades para caminhar
- pés cavos
- marcha em steppage
- arreflexia ou hiporreflexia difusa do tendão profundo
- força muscular reduzida
- sensação reduzida
- sintomas sensoriais temporários
- sintomas motores temporários
Outros fatores diagnósticos
- cirurgia prévia nos pés e tornozelos
- dificuldades de equilíbrio na infância
- fraqueza do tornozelo
- anormalidades sensoriais nas mãos e nos pés
- marcha digitígrada
- desenvolvimento motor tardio
- ataxia sensorial
- cifoescoliose
Fatores de risco
- história familiar de neuropatia, pés cavos (arcos dos pés elevados com pododáctilos em martelo) ou marcha irregular
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- estudos de condução nervosa (ECN)
Investigações a serem consideradas
- teste genético
- radiografia do quadril
- radiografias da coluna cervical, torácica, lombar e da pelve
- ultrassonografia de nervo
- biópsia de nervo
- teste de função pulmonar
Algoritmo de tratamento
todos os pacientes
Colaboradores
Autores
Carly E. Siskind, MS, CGCL
Clinical Assistant Professor (Affiliated)
Certified Genetic Counselor
Stanford Health Care
Stanford University
Stanford
CA
Declarações
CES has an unpaid position on the Charcot-Marie-Tooth Association Advisory board. CES is a consultant for Guidepoint, conducting approximately five consultations a year of which may include consults for Charcot-Marie-Tooth disease. CES has received institutional funding from an Inherited Neuropathies Consortium research grant, funded by the Muscular Dystrophy Association and the National Institute for Health. CES gives lectures to Genetics graduate students at Stanford University. CES has professional relationships with some authors of references cited in this topic.
Agradecimentos
Dr Carly E. Siskind would like to gratefully acknowledge Prof Richard A Lewis, her previous co-contributor to this topic.
Declarações
RAL is a consultant for Pharnext, CSL Behring, and Axelacare. He is on the Medical Advisory Board for GBS-CIDP Foundation, MGFA, and MGF of Ca. He has done expert testimony related to GBS, CIDP, and other neurologic disorders, and educational talks for AAN, AANEM, CSL Behring, and Optioncare. With the exception of Pharnext, none of these relationships are related to Charcot-Marie-Tooth disease. RAL is an author of a number of references cited in this topic.
Revisores
Reza Sadjadi, MD
Neurologist
Director, Charcot-Marie-Tooth (CMT) Center of Excellence
Assistant Professor of Neurology
Harvard Medical School
Boston
MA
Declarações
RS declares that he has no competing interests.
Pavel Seeman, MD, PhD
Associate Professor (Doc)
Head of the DNA Laboratory
Department of Child Neurology
Second School of Medicine
Charles University
Prague
and University Hospital Motol
Prague
Czech Republic
Declarações
PS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Saporta AS, Sottile SL, Miller LJ, et al. Charcot-Marie-Tooth disease subtypes and genetic testing strategies. Ann Neurol. 2011 Jan;69(1):22-33. Resumo
Shy M, Lupski JR, Chance PF, et al. The hereditary motor and sensory neuropathies: an overview of the clinical, genetic, electrophysiologic and pathologic features. In: Dyck PJ, ed. Peripheral neuropathy. Vol 2. 4th ed. Philadelphia, PA: WB Saunders; 2005:1623-58.
Yiu EM, Bray P, Baets J, et al. Clinical practice guideline for the management of paediatric Charcot-Marie-Tooth disease. J Neurol Neurosurg Psychiatry. 2022 May;93(5):530-8.Texto completo Resumo
Murphy SM, Laura M, Fawcett K, et al. Charcot-Marie-Tooth disease: frequency of genetic subtypes and guidelines for genetic testing. J Neurol Neurosurg Psychiatry. 2012 Jul;83(7):706-10. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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