| Phenotype details |
onset 22y with difficulty walking and Lt. lower limb weakness which extended to Rt. upper limb later; Mild cardiac problem; Muscle weakness, distal>proximal, Lt. leg & Rt. hand; Mild Claw toe; Mild pes cavus; Muscle wasting in distal of left leg & distal of right hand; Mild thenar & hypothenar atrophy; Tremor in right hand; Loss of tip-toe walking since 6-mo ago; Abnormal gait; Difficulty walking, running and climbing steps, mild; Elevated level of AST, ALT, LDH & CPK; Mild deformity in left ankle;Muscle biopsy showed slight myopathic atrophy with prominent internalization of nuclei and few basophilic degenerative/regenerative fibers associated with some moth-eaten fibers and secondary neurogenic changes fiber type grouping; EMG-NCV was in favor of a myopathic process mostly involving GC muscles, R/O Miyoshi type of dysferlinopathy. |