Nemaline myopathy (NM) is a genetically heterogeneous congenital myopathy due to mutations in different encoding proteins. Mutations in the nebulin (NEB) gene are the most common cause of autosomal recessive NM. Typical NEB-related NM is of infantile-onset but late-onset presentations with predominantly distal involvement have been reported in very rare cases. We presented the clinical and histological phenotype of three patients manifesting with prominent distal weakness with bilateral foot-drop of adult onset associated with NEB gene mutations.

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