Muscle Wasting and Weakness in Neurological Conditions

Q: Muscle Wasting and Weakness in Neurological Conditions

Hello： Many of the issues you mentioned are still under research. <br>It is recommended to discuss and analyze them with specialists in the "Neuromuscular Medicine" department at medical centers (such as Chang Gung, Veterans General, Shin Kong, National Taiwan University, etc.).

Muscle atrophy and lower limb weakness?

Dear Doctor,
Hello,
1.
I am 46 years old.
When I was 18, I became ill with myelitis and was bedridden.
After more than six months, I gradually recovered and was able to use a single cane to attend school and work, managing stairs as well.
Although my movements are a bit slower, I consider myself fortunate to have regained enough independence to live on my own.
2.
By the grace of fate, I have lived this way for over 20 years.
3.
In recent years, I have noticed a gradual loss of muscle mass in my lower body (waist, hips, thighs, calves, and feet), along with weakness in my lower limbs and increasing issues with bowel and bladder function.
I am currently 165 cm tall and weigh 50 kg.
I am struggling to maintain walking with a single cane.
4.
I have consulted doctors and undergone spinal MRI scans, but they have all indicated no significant changes or nerve compression, attributing my condition to normal spinal degeneration without any specific treatment.
I would like to ask the doctor:
a.
Regarding IGF-1 (Insulin-like Growth Factor 1), which is said to be the only hormone that promotes synthesis in the body, aiding in fat and muscle synthesis, would this be beneficial for me?
b.
I understand the importance of resistance training, but I am unable to lift my legs and need support to stand up after squatting.
Would EMS (Electrical Muscle Stimulation) devices available on the market be helpful for me?
c.
Two years ago, I learned about new immunotherapy drugs developed to promote muscle synthesis.
What is the latest progress on this?
d.
Regarding advancements in neurology and muscle health, could you provide any recommendations?
As a patient lacking knowledge, I hope you can enlighten me on these matters.
I look forward to your response.
Wishing you good health.
Sincerely,
April 8, 2018

Shen jing ji rou, 40~49 year old female. Ask Date: 2018/04/23

Dr. Jiang Junyi reply Neurology

Hello: Many of the issues you mentioned are still under research.
It is recommended to discuss and analyze them with specialists in the "Neuromuscular Medicine" department at medical centers (such as Chang Gung, Veterans General, Shin Kong, National Taiwan University, etc.).
This is because some medications may not meet the criteria for health insurance coverage.
Regarding muscle training, it is advisable to consult with a rehabilitation physician and physical therapist to plan a rehabilitation program.
Passive EMS (Electrical Muscle Stimulation) usually does not yield significant results.
I apologize for not being able to answer more in-depth questions.
Wishing you good health, peace, and joy.
Dr.
Tao, Shen Nei, cares about you.

Reply Date: 2018/04/23

More Info

Dear Patient,
Thank you for sharing your medical history and concerns regarding muscle wasting and weakness, particularly in the context of your previous spinal cord inflammation and the subsequent challenges you've faced. Your experience highlights the complexities of neurological conditions and their impact on muscle function and overall quality of life. Let’s address your questions one by one, while also providing some insights into the underlying mechanisms of muscle wasting and potential interventions.

A. IGF-1 and Muscle Synthesis
Insulin-like Growth Factor 1 (IGF-1) plays a crucial role in muscle growth and repair. It is known to promote protein synthesis and muscle hypertrophy, making it a focus of interest in muscle-wasting conditions. While IGF-1 can be beneficial, its use as a treatment should be approached cautiously. The body’s hormonal balance is delicate, and excessive IGF-1 can lead to unwanted side effects, including potential impacts on insulin sensitivity and increased risk of certain cancers. Before considering IGF-1 therapy, it is essential to consult with an endocrinologist or a specialist in metabolic disorders to evaluate your specific situation and determine if this approach is appropriate for you.

B. EMS Devices for Muscle Stimulation
Electrical Muscle Stimulation (EMS) devices can indeed be beneficial for individuals with muscle weakness, particularly when traditional resistance training is not feasible. EMS can help stimulate muscle contractions, which may promote muscle maintenance and potentially improve strength over time. However, the effectiveness of EMS varies among individuals, and it is crucial to use these devices under the guidance of a physical therapist or rehabilitation specialist. They can help tailor a program that aligns with your capabilities and ensure that you are using the device safely and effectively.

C. Advances in Immunomodulatory Treatments
Recent advancements in immunomodulatory therapies have shown promise in promoting muscle synthesis and combating muscle wasting. These treatments often target underlying inflammatory processes that contribute to muscle degeneration. While specific medications are still under investigation, some have shown potential in clinical trials. It is advisable to stay informed about ongoing research and discuss any new treatment options with your healthcare provider, who can provide insights based on the latest evidence and your unique medical history.

D. Neurological and Muscular Advances
The field of neurology and muscle physiology is rapidly evolving, with ongoing research aimed at understanding the mechanisms behind muscle wasting and developing new therapeutic strategies. Some areas of interest include:
1. Stem Cell Therapy: Research is exploring the potential of stem cells to regenerate damaged muscle tissue and restore function. While still largely experimental, this area holds promise for future treatments.

2. Gene Therapy: Advances in gene therapy aim to correct genetic defects that lead to muscle diseases. This approach is still in the early stages but has shown potential in preclinical studies.

3. Nutritional Interventions: Adequate nutrition, particularly protein intake, is vital for muscle health. Consulting with a nutritionist can help optimize your diet to support muscle maintenance.

4. Physical Rehabilitation: Engaging in a structured rehabilitation program tailored to your abilities can significantly improve your functional capacity. Physical therapists can provide exercises that focus on strength, flexibility, and balance, which are crucial for maintaining independence.

Conclusion
Your journey through muscle wasting and weakness is undoubtedly challenging, but there are avenues for support and intervention. It is essential to work closely with your healthcare team, including neurologists, physical therapists, and nutritionists, to develop a comprehensive plan tailored to your needs. Regular follow-ups and open communication with your medical providers will ensure that you stay informed about the latest advancements and receive the best possible care.

Wishing you strength and health as you navigate this journey. Please feel free to reach out with any further questions or concerns.

Best regards,
Doctor Q&A Teams

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