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weakness, numbness, fatigue and difficulty in co-ordination. These are because of spastic weakness and loss of reflexes in the muscles. Not only the muscles of the extremities but also the muscles of the bladder, bowel and male reproductive organs are affected. The management is through pharmacotherapy and physiotherapy.

Parkinson's disease:

This is also a progressive neurologic disorder but the symptoms are muscle stiffness or rigidity, muscle weakness, loss of postural reflexes, tremor and slowness of movements. The disease not only affects the muscles of the extremities but also affects the face. The muscle movement of the face is affected in later stages of the disease giving very little expressions which is described as masklike features. The management depends upon the symptoms exhibited by the person.

Huntington's disease (HD):

HD is a chronic, progressive, hereditary disease of the nervous system characterized by a constant twisting and uncontrollable movement of the entire body musculature. The physiology of the entire muscular system is affected. The facial muscle causes movements of tics and grimaces, speech becomes slurred, chewing and swallowing becomes difficult and there is constant danger of choking and aspiration. In later stages all the activities are affected including sitting and walking, and the person becomes confined to bed. There is no treatment to halt or reverse the disease.

Myasthenia gravis:

It is a disorder affecting the neuromuscular transmission of the voluntary muscles characterized by excessive weakness and easy fatigablity of the same. The onset of disease is between 15 and 35 for women and above 40 for men. The lack of normal receptors on the postsynaptic membrane prevents transmission of impulses from nerve to muscles. Doing simple activities of daily living like combing, chewing and talking will also cause tiredness. The symptoms depend upon the muscle that is affected.

The treatment is with anticholinesterase, immunosuppressive therapy and plasma exchange.
Amyotrophic lateral sclerosis: ALS is a disease of the nerve cells controlling the muscles and the cause it unknown. The clinical manifestations include muscle weakness, muscle atrophy and muscle twitches. There is progressive muscle weakness and atrophy noticed in arms, trunks and legs. Muscle spasticity is present and stretch reflexes becomes overactive. ALS is treated symptomatically and rehabilitative measures help a lot.

Muscular dystrophy:

They are a group of chronic muscle disorders characterized by progressive weakening and wasting of skeletal or voluntary muscles. The treatment is usually supportive and symptomatic.

Since diseases of the muscles do not show explicit symptoms during initial stages, it is always better to consult your physician in the early stages when you feel any sort of muscle weakness or pain. Athletes and elderly people need to get checked frequently by trained physicians as they are more prone to muscle related diseases.

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