What Is Amyotrophy?

Muscle atrophy (myatrophy; myophagism) refers to muscle contraction caused by striated muscle dystrophy, thinning or even disappearance of muscle fibers. Mostly caused by muscle disorders or nervous system dysfunction, the main causes are: neurogenic muscular atrophy, muscular muscular atrophy, disused muscular atrophy, and other causes of muscular atrophy. In addition to the pathological changes of the muscle tissue itself, the nutritional status of muscles is closely related to the nervous system. Spinal cord disease often leads to muscular dystrophy and muscle atrophy. Patients with muscular atrophy stay in bed for a long time due to muscle atrophy and muscle weakness, and are prone to complicated with pneumonia and pressure ulcers. In addition, most patients have symptoms of bulbar palsy, which poses a great threat to patients' lives.

Basic Information

English name

myatrophy; myophagism

Visiting department

Neurology

Common locations

muscle

Common causes

Mostly due to muscle disorders or nervous system dysfunction

Common symptoms

Muscle atrophy, muscle weakness, medulla oblongata, pneumonia, pressure ulcers, etc.

Contagious

Causes of Muscular Atrophy

Neurogenic muscular atrophy

Common causes are disuse, nutritional disorders, ischemia and poisoning. Anterior horn lesions, nerve roots, plexus, and peripheral nerve lesions can all cause conduction disturbances of nerve excitement impulse, thereby disabling some muscle fibers and producing wasteful muscle atrophy. On the other hand, when any part of the current motor neuron is damaged, the acetylcholine released from its peripheral parts is reduced, and the sympathetic nutritional effect is weakened, causing muscle atrophy.

2. Myogenic muscular atrophy

It is caused by muscle disease and may include other factors, such as patients with muscular dystrophy of shoulder strap or facial shoulder brachial type, confirmed by spinal muscular atrophy through morphological examination. Examination of animals with muscular dystrophy using microelectrode technology showed that about one-third of the functional denervated muscle fibers.

Two major types of factors can cause "muscle atrophy": nerve damage is called neurogenic muscle atrophy; disease of the muscle itself is called muscle derived atrophy.

Clinical manifestations of muscular atrophy

1. Thigh muscle atrophy

Quadriceps atrophy is the main cause, and thigh muscle atrophy is common in patients with femoral head necrosis and lower extremity brakes. All patients with mid and advanced femoral head necrosis have atrophy of thigh muscles in affected limbs. Part of the disused thigh muscle atrophy can be recovered, and in a few cases of femoral head necrosis, the thigh muscle atrophy cannot be recovered for life, which seriously affects the patient's walking distance and quality of life.

2. Calf muscle atrophy

It refers to striated muscle malnutrition, muscle volume shrinks than normal, muscle fibers become thinner or even disappear.

3. Scapular muscle atrophy

Is the symptoms and clinical manifestations of progressive proximal muscle atrophy of the extremities. Progressive proximal muscle atrophy of the extremities is usually myogenic atrophy, which is obvious in the proximal and trunk muscles of the extremities, and often manifests as atrophy and weakness of the scapular and pelvic girdle muscles.

4. Myogenic facial muscle atrophy

It is caused by muscle disease and may include other factors, such as patients with muscular dystrophy of shoulder strap or facial shoulder brachial type, confirmed by spinal muscular atrophy through morphological examination. On the other hand, when any part of the current motor neuron is damaged, the acetylcholine released from its peripheral parts is reduced, and the sympathetic nutritional effect is weakened, causing muscle atrophy.

5. Atrophy of interosseous and intermuscular muscles

It usually starts with small hand muscle weakness and gradual muscle atrophy, which can affect one or both sides, or the opposite side after starting from one side. The palms are flat due to atrophy of the big and small intermuscular muscles, and the claw-shaped hands are atrophic of the interosseous muscles. Muscle atrophy extends upwards, gradually invading the forearm, upper arm, and shoulder straps. Myofibrillation is common and can be confined to certain muscle groups or is widely present. It can be easily induced by flapping with your hands. A small number of muscle atrophy can start from the tibialis anterior and fibula muscles of the lower limbs or from the extensors of the neck. Individuals can also start from the proximal muscles of the upper and lower limbs.

6. Muscle atrophy muscle strength classification

(1) Level 0: Completely paralyzed, unable to do anything free and incompetent.

(2) Grade : completely paralyzed, slight muscle atrophy can be seen during limb movement, but the body cannot move.

(3) Grade II: The limbs can move in parallel on the bed, but cannot be lifted off the bed.

(4) Level III: The limb can overcome the attraction of the center of the earth and lift off the table.

(5) Level IV: The limb can do exercises against external resistance.

(6) Level : Normal muscle strength and free movement.

Muscle atrophy test

1. Electromyography (EMG).

2. Nerve conduction velocity, including motor nerve conduction velocity, sensory nerve conduction velocity, F wave, H reflex.

3. Evoked potentials, including brainstem auditory evoked potentials, visual evoked potentials, and upper and lower extremity somatosensory evoked potentials.

4. Freehand muscle strength check.

5. Muscle tension check.

6. Muscle circumference measurement.

Muscle atrophy treatment

1. Standardize rehabilitation exercise therapy

Patients with limb dyskinesia caused by muscle atrophy can significantly reduce or reduce the sequelae of paralysis after regular exercise therapy.

Some people mistake sports therapy as particularly simple, or even equate it with "exercise". They are eager to achieve success and often do more with less, and cause joint muscle damage, fractures, shoulder and hip pain, increased spasms, abnormal spasm patterns and abnormal steps. State, as well as foot drop, varus and other problems, namely "misuse syndrome".

The coordinated rehabilitation of the patient's joint mobility, muscle tone and antagonism should not be ignored, so as to prevent the patient's muscle strength from returning to normal, but leaving abnormal movement patterns.

2. Emphasize muscle coordination training

Inappropriate muscle training can aggravate the spasm, and proper rehabilitation training can alleviate this spasm and make the body movements coordinate. Once the wrong training method is used, if repeated gripping is performed repeatedly with the affected hand, the flexor synergy of the affected upper limb will be strengthened, and the muscle spasms responsible for joint flexion will be aggravated, resulting in elbow flexion, wrist pronation, and flexor fingers Malformation makes it more difficult to restore hand function. In fact, muscle wasting limbs and dyskinesias are not only a problem of muscle weakness, but the uncoordinated muscle contraction is also an important cause of motor dysfunction. Therefore, one cannot mistake the rehabilitation training as strength training.

3. Other treatments

Low frequency or medium frequency electrical stimulation, neurotrophic drugs, combined with acupuncture / electroacupuncture and massage.

Muscle atrophy self-regulation

In addition to asking a doctor for treatment of muscular atrophy, self-regulation is very important:

1. Stay optimistic and happy

Stronger long-term or repeated emotional changes such as nervousness, anxiety, irritability, and pessimism can make the cerebral cortex excite and inhibit the balance of the imbalance process, and promote the development of muscle atrophy.

2. Reasonably allocate diet structure

Patients with muscular atrophy need a high-protein, high-energy dietary supplement that provides the substances necessary for the reconstruction of nerve cells and skeletal muscle cells to enhance muscle strength and muscle growth. Early use of high-protein, vitamin, phospholipid, and trace element-rich foods, and Actively cooperate with qi and spleen medicated diets, such as yam, astragalus, white lotus, tangerine peel, ginseng, lily, etc., fast food spicy, quit smoking and alcohol. Patients in the middle and advanced stages are mainly high-protein, high-nutrition, energy-rich semi-liquid and liquid foods, and use less food and more meals to maintain the nutrition and water-electrolyte balance of patients.

3. Work and rest

It is forbidden to perform functional exercises forcibly, because forced sexual exercises will fatigue skeletal muscles, which is not conducive to the recovery of skeletal muscle function, regeneration and repair of muscle cells.

4. Prevention of colds and gastroenteritis

Patients with muscular atrophy have low autoimmune function or some kind of immunodeficiency. Once the patients with muscular atrophy have a cold, their condition becomes worse and their course prolongs, and their muscle atrophy and muscle jumps become worse. Especially patients with ball paralysis are prone to complicated with lung infection. Prompt prevention and treatment, poor prognosis, and even endanger patients' lives. Gastroenteritis can cause intestinal bacterial dysfunction, especially viral gastroenteritis can damage the anterior horn cells of the spinal cord to varying degrees, thereby causing the muscle atrophy to repeat or worsen. Maintaining normal digestive function in patients with muscular atrophy is the basis of rehabilitation.