Pseudohypertrophy is a muscle enlargement due to vaccine proliferation, which is associated with functional losses. Most pseudohypertrophies occur in the context of higher-level muscular diseases. Above all, the therapy corresponds to a movement therapy to restore full mobility.

What is pseudohypertrophy?

The disease group of muscle hypertrophy includes diseases characterized by a pathological increase in muscle tissue after overwork. A similar phenomenon exists in pseudohypertrophy. It is the enlargement of a skeletal muscle that is macroscopically visible. At the same time as enlargement, there are functional losses.

The patient thus loses strength in the affected muscle. The differentiation from muscle hypertrophy is a histological one. In pseudohypertrophy, the interstitial connective tissue proliferates. It is the connective tissue between the parenchymal cells of the muscles. In hypertrophy, the connective tissue does not multiply, but the parenchyma cells enlarge and cause the organ enlargement.

The causes of hypertrophy and pseudohypertrophy are not the same. Ultimately, for example, pseudohypertrophy is often preceded by muscle hypertrophy. In this case, pseudohypertrophy is a symptom of hypertrophy. The combination of pseudo-hypertrophy and hypertrophy is characterized mainly by some groups of genetic diseases.

causes

The cause of the enlarged muscle in the context of a pseudohypertrophy is a Vakatwucherung. It is the proliferation of connective tissue or fatty tissue that takes place in a vacant space of the human body. Vakatwucherungen are therefore adaptation reactions of human cells and tissues.

The space for the growths is usually released in the context of atrophy. This previous muscle atrophy can take place in the context of neuromuscular diseases. Thus, the primary cause of pseudo-hypertrophy is often a primary disease such as Duchenne muscular dystrophy with a predilection site in the calf muscles. When a primary disease such as Duchenne muscle atrophy causes pseudohypertrophy, genetic factors usually play a role.

For example, atrophy in this disease is caused by a mutation in the dystrophin gene. Also in the context of limb girdle dystrophies, pseudohypertrophies can be established based on genetic mutations. The same applies to primary diseases with a neurological change in muscle tissue. In short, the primary cause of pseudohypertrophy is the primary cause of primary disease.

Symptoms, complaints & signs

Patients with pseudohypertrophy suffer from an increase in muscle volume due to adipose tissue retention or as part of connective tissue remodeling within the musculature. This phenomenon leads to functional loss of the affected muscle. Because unlike hypertrophy, muscle cells do not increase, pseudohypertrophy is most often associated with muscle weakness.

For example, depending on the location of pseudohypertrophy, patients may suffer from gait disorders due to muscle weakness. When upper limb muscles are affected by pseudo-hypertrophy, these disorders often also manifest themselves in the inability to grip or in a general awkwardness. Depending on the primary disease, additional symptoms may be added.

A pseudohypertrophy in the context of Becker-Kiener or Duchenne muscular dystrophies is usually pseudohypertrophy in the calf region and symptomatically causes so-called gnome calves. In myotilinopathies such as the limb girdle dystrophies LGMD1A may be accompanied by speech disorders. Pseudohypertrophies in the heart muscle are usually due to cardiomyopathies. These pseudohypertrophies are usually preceded by a heart attack.

Diagnosis & disease course

To diagnose pseudohypertrophy, the doctor first performs imaging procedures. These methods include, above all, computed tomography, magnetic resonance imaging and ultrasound. To rule out neurological factors as the cause of muscle weakness, magnetic resonance imaging is usually the most helpful tool.

The diagnosis of pseudohypertrophy must be distinguished from true hypertrophy. This differential diagnostic distinction is usually made by microscopic examinations of muscle tissue, which is taken in a muscle biopsy. Since hypertrophy and pseudo-hypertrophy are associated with the proliferation of various types of tissue, the delineation of the two phenomena following histopathology can be assessed following biopsy.

In most cases, the doctor also tries to diagnose the primary cause in the diagnosis. Genetically related primary diseases can be confirmed or excluded, for example, in the context of molecular genetic analyzes.

complications

Due to the pseudo-hypertrophy sufferers suffer from a significant increase in muscle. However, this increase has a very negative effect on everyday life and also on the movement of the patient and can lead to restricted mobility or to gait disorders. Also a muscle weakness occurs due to the pseudohypertrophy not uncommon and makes the affected person's everyday life considerably.

Pseudohypertrophy also affects the face, which can lead to speech disorders. The development of children is significantly limited and negatively affected by this disease. Likewise, the pseudohypertrophy can have a negative impact on the heart of the person affected, so that in the worst case can lead to a heart attack. The treatment of this disease is unfortunately not causally possible.

For this reason, the treatment of pseudohypertrophy is aimed primarily at reducing muscle weakness. In some cases, however, those affected depend on the help of other people in their everyday lives. Also a psychological treatment is necessary in many cases. Whether pseudohypertrophy reduces life expectancy can not be universally predicted.

When should you go to the doctor?

Loss of physical performance should be presented to a doctor. If general muscle strength decreases, a follow-up visit is recommended to clarify the cause and prepare a treatment plan. If there are restrictions on the possibilities of movement, disorders of locomotion or habitual physical activity can no longer be performed, a doctor should be consulted.

With gait uncertainties, swelling on the body or incomprehensible growths a doctor is needed. Deposits of the fatty tissue, deformations or changes in the muscles should be examined. If the person concerned gains weight or body circumference for no apparent reason, there is cause for concern. A visit to a doctor is required because pseudohypertrophy, if untreated, has a progressive disease course.

Speech disorders are to be understood as an alarm signal of the organism. They should be investigated as soon as possible and clarified. A general malaise, a feeling of illness or inner weakness are to be presented to a doctor. If objects of everyday use can no longer be held or the hand can not form a firm grip, a doctor should visit.

Irregularities of the heart rhythm, tachycardia or changes in blood pressure are indications of a health impairment. Since there is a risk of a heart attack and thus a health emergency, a doctor should be consulted immediately. If it comes to sleep disorders or rapid fatigue, a visit to a doctor is also required.

Therapy & Treatment

In most cases, no causal therapies are available to treat pseudohypertrophy. This is especially true when the phenomenon occurs in the context of genetic mutations. Gene therapies are currently not a treatment option and remain for the time being an object of medical research. Pseudohypertrophy can only be treated symptomatically in the context of these diseases.

The main goal of this treatment is to reduce muscle weakness. The improvement and maintenance of self-reliance and mobility should ensure the lasting self-sufficiency and the ability to participate in social life. Treatment for this purpose usually takes place through an interdisciplinary team consisting of nurses, physiotherapists, occupational therapists, psychologists and possibly social workers.

The rehabilitation of the muscles promote exercise therapy with mild to moderate stress. Walking, swimming and cycling could be on the program. The muscular endurance is improved and the performance of the cardiovascular system increases. For some primary diseases, in addition to the movement therapy measures, drug therapy options are also available.

prevention

A precautionary measure for pseudohypertrophy may be regular exercise. Although there are no preventive measures available for certain primary diseases with pseudo-hypertrophy, the regular weakness of muscle weakness in pseudo-hypertrophy can be kept to a moderate level.

aftercare

In pseudo-hypertrophy, affected persons usually have only a few and even limited measures and options for follow-up care. For this reason, patients should consult a doctor at the first symptoms and signs of the disease, so that further complications can be prevented. As a rule, no self-healing can occur, so sufferers are usually always dependent on medical examination and treatment.

The sooner a doctor is visited, the better is usually the further course of the disease. In most cases, the treatment is carried out with the help of various surgical interventions, by means of which the tumors can be removed. After such an intervention sufferers should rest and spare their body.

Physical exertion and stressful activities should be avoided. Regular checks by a doctor are essential. This can prevent infections and inflammation. The patient's life expectancy is often limited and reduced by pseudohypertrophy. Further measures of follow-up care are usually not available to the patient.

You can do that yourself

Those who suffer from pseudohypertrophy are usually prescribed a movement therapy. It is especially important to comply with these therapy appointments, because with targeted movement, the weakened muscles are strengthened again. Consistent adherence to therapy gives you the chance to regain the full strength, mobility and agility of the affected muscles.

If there are speech disorders due to the disease, the same applies to the prescribed logopedic treatment. Of course, the prescribed medication should be taken consistently according to the instructions of the doctor. The fact that the disease can usually only be treated symptomatically puts a lot of strain on those affected. Here is an accompanying psychotherapy advised. This is especially true for patients who depend on the help of others.

A sporting activity in everyday life beyond the prescribed therapies also pays off. Patients should walk, walk, swim and / or cycle a lot. Regular exercise promotes the cardiovascular system as well as muscular endurance.

On the regular tension but should also follow the regular relaxation. Many patients who suffer from pseudohypertrophy tend to retire socially. This should be actively prevented, for example, with periodic Stammtisch meetings with friends. The connection to self-help groups is useful. Corresponding contacts and further information are provided by the DGM German Society for Muscular Diseases (www.dgm.org).

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