Charcot Marie Tooth

Question 1

what is the etiology of CMT

Answer 1

the most common inherited disorder affecting nerves - autosomal dominant motor and sensory neuropathy causing peroneal muscular atrophy

Question 2

describe the progression of CMT

Answer 2

initially involves peroneal nerve and foot but can later involve forearm and hands

Question 3

what mutations cause the CMT presentation

Answer 3

mutations in the proteins responsible for schwann cell myelination in the PNS

Question 4

describe the pathogenesis of CMT

Answer 4

slow, progressive disorder beginning with distal SYMMETRICAL weakness, atrophy, and diminished DTRs

Question 5

classic presentation of CMT?

Answer 5

pes cavus and hammer toes

Question 6

what is the mechanism behind the pes cavus deformity in CMT?

Answer 6

the everters and long toe extensers are no longer innervated effectively by the peroneal nerve therefore the antagonist muscles (long toe flexors) operate unchecked. They become shortened pulling up the arch and inverting the foot

Question 7

Tx for CMT?

Answer 7

symptom management, surgery, PT

Question 8

what can PT do for CMT

Answer 8

assess pt for orthotics, prevent contractures, and maximize function

Question 9

ideal orthotic for CMT

Answer 9

PTB orthosis

Question 10

what should we exercise?

Answer 10

strengthen anything that will fire with progressive resistive exercise