Myopathy

Myopathy or muscular disease that includes muscle inflammation and muscle weakness. Myopathies affecting the skeletal muscle can have many origins - inherited, drug induced or endocrine issues. Mostly a Myopathy is transitory in nature and rarely results in complete loss of function. Muscular Dystrophy is possibly an exception in that it can be severe and sometimes even fatal if it occurs early in life.

Genetic Myopathies

These inherited Myopathies occur due to a genetic defect in the synthesis of a protein. There are many kinds in genetic Myopathies:

• Central Core Disease : Weakness in the muscles affecting hips and legs resulting in problems in running, jumping and climbing stairs
  
  
• Centronuclear Myopathy or Myotubular Myopathy : Weakness in the muscles affecting face, legs, arms and the trunk resulting in drooping upper eyelids, facial weakness or foot drop
  
  
• Myotonia Congenita : Muscles in the face, arms or legs are affected and result in muscular stiffness (myotonia) after contracting of muscles - usually after a trigger in the form of stress, fatigue, cold or a long period of no motion
  
  
• Nemaline Myopathy : Weakness in the muscles of arms, legs and the trunk resulting in poor or absent reflexes, long or narrow face, abnormal facial features
  
  
• Paramyotonia Congenita : Stiffness of muscles in the face, forearms and hands
  
  
• Periodic Paralysis : Temporary muscle weakness episodes in hypokalemic form (low calcium) as a result of vigorous exercises, intake of food high in carbohydrates, stress, alcohol, insulin, pregnancy or infection. In the hyperkalemic form (high calcium) it can occur as a result of vigorous exercises, stress, pregnancy, skipping food, high potassium levels or steroids
  
  
• Mitochondrial Myopathies : Progressive weakness of muscles in the eye (ocular myopathy) or arms and the legs or multisystem issues
  
  

Endocrine related Myopathies : Hormone deficiency can cause Myopathies. Hyperthyroid Myopathy is the result of excess secretion of thyroxine from the thyroid gland affecting muscles in the shoulders, hips or eyes. Hypothyroid Myopathy occurs when too little hormone is secreted and results in stiffness, cramps and weakness of legs and arms muscles.

Inflammatory Myopathies : Some Myopathies result in inflamed, weakened or wasted muscles. Dermatomyositis affects the connective tissue and the severity of the affected muscle loss can result in crippling movement.

Chronic muscle inflammation is called as Myositis. It is usually caused due to allergic reaction, infectious disease or rheumatism. Sometimes Myopathies are hereditary. Symptoms of Myopathy can also include cramps, spasms and stiffness. There is progressive deterioration in muscle strength resulting in pain and fatigue on walking and tripping and falling. This is not due to nerve dysfunction. Some patients might notice facial weakness, foot drop, droopy eyelids and poor reflexes in affected muscles.

Trigeminal Neuralgia

Trigeminal Neuralgia is a painful condition wherein a patient suffers attacks of facial pain. The pain associated with trigeminal neuralgia is shooting and jabbing, much like sudden burst of live wires on the face. While these episodes of pain may be few and far between in the initial stages, the attacks are more frequent and painful as the disease progresses. It can be felt on a small portion of the face or the larger area. In most cases, it affects just one side of the face. The trigeminal nerve, originating from deep in the brain serves the facial area. Any disturbance in its function leads to trigeminal neuralgia or tic douloureux. The possible causes for the pain are stroke, tumor or multiple sclerosis. Usually this disorder is noticed in persons over 50 years and women seem to be more affected by it than men.

The pain associated with trigeminal neuralgia is so intense that it affects the day-to-day life of the patient. Activities like eating, drinking, shaving, brushing the teeth and talking can become agonizing. Consequently, it leads to anxiety and irritability and nutritional deficiencies since the patient is likely to avoid eating. A patient may need to be hospitalized if the pain is acute. An MRI of the head may be suggested to aid diagnosis.

Trigeminal Neuralgia is treated with carbamazepine - a drug used to treat seizures and convulsions. Other drugs include baclofen, gabapentin, clonazepam, lamotrigine, topiramate and sodium valporate. But these drugs are not without unpleasant side effects. Percutaneous stereotactic radio frequency thermal rhizotomy (PSRTR) is a procedure whereby a doctor passes electric current to damage the nerve fibers that cause pain. Alternatively MVD (Microvascular decompression) can also ease pain without damaging any part of the trigeminal nerve. But there are inherent risks such as facial weakness or reduced hearing. High dose radiation is used to damage the root of the trigeminal nerve. This can be successful in reducing pain. Percutaneous glycerol rhizotomy (PGR) is a surgical procedure involving injection of small amounts of sterile glycerol into the skin to block pain signals.

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Side Effects of testosterone patch: Testosterone patch side effects range from increased body hair and irritation on the patch site to URI.

Dosage of Testosterone patch: