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14 | InTouch APRIL 2022 a physician or specialist may be necessary. Problems with the lower digestive tract may result in cramps, constipation or diarrhoea. Individuals with DM1 are at greater risk of developing gallstones due to weakening of the gallbladder – a sac under the liver which squeezes bile into the intestines. Symptoms are difficulty digesting fatty foods and pain in the upper right part of the abdomen. Surgery is a possibility to remove the gallstones. Women with DM1 may experience difficulties during pregnancy due to weakness and myotonia of the uterus. These may involve excessive bleeding or ineffective labour. Caesarean section may be advised. Blood pressure tends to be low in individuals with DM1, however this does not usually pose a problem. Some people may seem slow, dull, uncaring or depressed. As with most aspects of DM, there is a wide range of severity of the mental and emotional symptoms of the disorder. In adults, severe mental impairment is not very common, but an overall inability to“settle down to something,” apply oneself to work or family life, concentrate or become engrossed in a task is often reported. Cataracts – cloudy areas over the lens of the eye – are common in individuals with DM1. Individuals may notice haziness, blurriness or dimness that will worsen over time. This can be corrected with surgery. Diabetes mellitus is a condition characterised by abnormally high blood and urinary sugar levels. Most individuals with DM1 suffer from a mild type referred to as ‘insulin resistance’. Blood and/or urine tests may be carried out to test MYOTONIC DYSTROPHY (DM) for this, and if present, individuals will often be advised to change diet and exercise habits or to take medication. DM1 may be only mildly experienced, and this form does not tend to impact significantly on an individual’s life. They may only experience mild myotonia, cataracts, or diabetes mellitus. They can lead fully active lives and a normal or minimally shortened lifespan. Due to the mild nature of the symptoms, DM often goes undiagnosed. DM2 – Proximal Myotonic Myopathy DM2 is clinically similar to DM1 and tends to have a differing pattern of muscle weakness. There is greater Note: Mothers with DM can also pass on the DM1 or DM2 form. A child can also inherit myotonic dystrophy from the father, but it’s almost always the DM1 or DM2 form. Babies with Congenital myotonic dystrophy have severe muscle weakness and hypotonia (loss of muscle tone). This includes weakness of the face and children characteristically have a ‘tented’ upper-lip. Babies are also often born with clubfeet. Surgical correction is necessary to enable the child to walk. The muscles that control breathing and swallowing are also involved. These problems can be life-threatening and need early intervention and intensive care to Note: Mothers with DM can also pass on the DM1 or DM2 form. A child can also inherit myotonic dystrophy from the father, but it’s almost always the DM1 or DM2 form. weakness in proximal limb muscles, such as the upper leg, and less so in the face. Myotonia is often mild or not present at all. Individuals with DM2 may have minor cognitive difficulties. Cataract, heart problems and diabetes also occur as in DM1, while other complications are rare. Congenital Myotonic Dystrophy Congenital myotonic dystrophy is a form of DM that is present at birth, and only occurs in individuals with mothers with DM1. In many instances, the mother’s condition is so mild that having a baby with congenital myotonic dystrophy is the first indication that the mother has DM. Congenital myotonic dystrophy is significantly more severe than other DM1 or 2 and affects boys and girls equally. improve the chance of survival. This may include the use of artificial ventilation and a feeding tube inserted into the stomach. Muscles used for speech are often affected and hearing can also be impaired. Speech therapists may be beneficial. Weakness of the eye muscles can result in strabismus, a condition where the eyes do not work together. This can be corrected with surgery. Myotonia is not present in babies with congenital myotonic dystrophy, however if the infant survives, he or she may develop myotonia later in life. Motor function gradually improves in surviving children and they are usually able to walk. However they will develop the same clinical signs of DM1 later in life.