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Diagnosing
- CMT and reflexes
Q: Mark McCowan asks: Have you seen any statistics on how many or
how few people with CMT have reflexes when tested by a doctor with the little
rubber hammer? I have communicated with one other person with CMT who also
has zero reflexive action.
Dr. Parry answers: "I don't have exact statistics but it varies
with different types of CMT. With CMT 1, the most common type, reflexes
are nearly always absent. I used to say that they were always absent but
have seen a few patients (less than 10 out of the many hundreds of CMT patients
I have seen) who do still retain the reflexes at least in the early stage
of their disease. In other forms of CMT the ankle reflexes are almost always
lost but those at the knees and in the arms are often present until the
disease is very advanced."
Mark observes: From Dr. Parry's reply it would seem a logical step
that anyone who knows they have no reflexes or limited reflexes be tested
for CMT. As he says it is normal for Type I, which is also the most common,
to have no reflexes.
Diagnosing - Is a high sediment level in blood an indicator
of CMT?
Question off the Internet - no name.
I was injured in an auto accident in 1993 with herniated disks in neck
and back and nerve damage in my arms. I have undergone numerous testing
both here in New Bedford, MA. and at Lahey Clinic in Burlington, MA. Problems
have continued to develop and in 1998 it was found that the sediment level
in my blood was extremely high. I am told it should be between 0-20. Right
now mine is 93 and was up to 120 in 1998. I have tried to get to the reason
why it is so high, but have not received any real answer. I was told that
sed levels are high in lupus and rheumatoid arthritis patients. So far,
they have not diagnosed me with either (thank goodness). However, after
seeing hematologists and neurologists at Lahey, I was told that whatever
is happening is chronic, but that's all they really came up with. I wondered
if a high sed level is an indicator of CMT? Any info would be appreciated.
Dr. Parry answers: The sed rate is very non-specific -- if it is
chronically high then there is likely some source of inflammation. It
is not up as a rule in CMT -- it can be up in a person with CMT, but not
due to CMT per se. Elevations can be due to: polymyalgia rheumatica, temporal
arteritis, lupus, rheumatoid arthritis, mixed connective tissue disease,
chronic infection, inflammatory bowel disease, uremia, hypothyroid cancer
(gastric and colon), asthma, multiple myeloma, to mention a few!
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