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Myopathy is a term which means "muscle disease". Muscle disease is either chronic or acute. Chronic inflammation of the muscle tissue is called "myositis". The three primary types of chronic inflammatory myopathy are called dermatomyositis, polymyositis and inclusion body myositis.
The cause of the muscle inflammation seen in myositis can be because of a medication, exposure to a toxin or an allergic reaction. Some are idiopathic and have no observable cause. Some individuals can have an autoimmune disease that attacks the muscle cells and causes chronic inflammation. The immune cells can attack blood vessels supplying muscles, connective tissue within the muscles and the muscle fibers themselves. The condition affects adults and children alike. Dermatomyositis is more common in children and both polymyositis and dermatomyositis occur more frequently in woman than men. There is a form of polymyositis that isn't very common but that occurs in children aged 2 to 15. Those who develop inclusion body myositis are usually greater than aged 50.
The symptoms of myopathy, especially inflammatory myopathy, include muscle weakness that occurs in the proximal muscles before distal muscles. There is fatigue when standing for long periods of time or if one walks a great distance. The person's balance can be poor and, in severe cases, there can be difficulty breathing or swallowing. The muscles may be sore to the touch.
In polymyositis, the skeletal muscle is affected on both sides of the person's body. It is usually seen in middle age (ages 31-60) and makes it difficult for the individual to speak, swallow or get up from a seated position. Climbing, lifting or reaching overhead are all difficult tasks. There can be shortness of breath and arthritic symptoms. Heart arrhythmias are not uncommon.
In dermatomyositis, there is a particular skin rash that can occur before or during the muscle weakness. Muscle weakness is progressive, as in other forms of myositis. The rash usually occurs on the face but can occur on the neck, elbows, knees, toes and knuckles. The upper back and chest can also be involved in rashes. There can be associated weight loss, fever, inflammation of the lungs and a particular sensitivity of the eyes to light. There can be calcium deposits forming underneath the skin-a condition called calcinosis. This can happen within a year of having the disease or can happen many years after developing this form of myopathy. Children get calcinosis more often than adults. You can get other types of collagen vascular diseases or autoimmune diseases along with dermatomyositis.
In inclusion body myositis, there is progressive muscle weakness and wasting of the muscles, both proximally and distally. One side of the body can be affected with the other side not affected. The muscle fibers have small holes in them when looked at under the microscope. These holes are called vacuoles. The most common first symptoms are tripping and falling. There can be distal symptoms, such as difficulty buttoning one's clothing and pinching things. Difficulty swallowing is a common symptom of this condition.
In juvenile myositis, kids of around 2-15 become affected with proximal muscle weakness. There can be swelling or edema of the body, especially in the legs. There can be contractures of the tendons of the muscles so that he person has difficulty walking. Skin rashes are likely and these are children who often have swallowing difficulties and problems breathing. Calcinosis happens in up to 30 percent of cases.
Doctors diagnose the various myopathies using muscle biopsy and a complete physical exam. The finding of proximal and progressive muscle weakness is likely to be a sign of polymyositis or dermatomyositis. A muscle biopsy may show muscle death, stress on the muscle fibers or inclusion bodies within the muscles.
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