| Subject: MDA Ask the Experts' website MULTIPLE DISABILITIES |
Author:
Joyce Fisher
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Date Posted: 18:06:10 12/05/05 Mon
Author Host/IP: 67-137-251-84.bras01.cha.wv.frontiernet.net/67.137.251.84
MDA Ask the Experts'
http://www.mdausa.org/experts/question.cfm?id=3337
SUBJ (05/03): DMD WITH MULTIPLE DISABILITIES
My only child is 13 years old. He has Duchenne muscular dystrophy (DMD) and has no other conditions other than allergies. Recently while talking with parents who have children with DMD, I learned that they have other children with different disabilities (e.g., deafness, autism). Often I hear that even the child with DMD may have one of these other disabilities. One mother has a 21-year-old daughter with autism and deafness and her 14-year-old son has DMD. Is this common or rare and what causes some families to have children with multiple disabilities? Is this a genetic issue?
REPLY from MDA: Leslie Morrison, M.D., MDA Clinic Director, University of New Mexico School of Medicine, Albuquerque, NM
There are a few reports of boys with Duchenne muscular dystrophy (DMD) having autistic features. I have followed only one such wonderful young man, who demonstrated exceptional art skills. Although we know that dystrophin (the missing protein in muscle of boys with DMD) is also present in the brain, the function has not yet been sorted out. It is not uncommon for boys to have a somewhat lower IQ than their siblings but it is rare to exhibit autism. IQ does not appear to get progressively lower over time. In a recent article from Kamagai et al. from Japan, eight of 94 boys with DMD, and two out of 43 boys with BMD were also diagnosed with autism. There are a number of ongoing studies of how the brain functions in DMD.
Increased vulnerability of the auditory system to noise exposure has been described in the mdx mouse and there have been a few families with deafness that maps to the same area of the X chromosome as the dsytrophin gene, but that showed no signs of muscular dystrophy in males or females. It was recommended that boys with DMD/BMD be screened periodically for hearing loss.
Autism and hearing loss in male siblings over 6-8 years of age or noncarrier female siblings of affected boys without weakness would appear to be unrelated to the DMD mutation. Without an individual family medical history, it isn't possible to know if these other problems are genetic, but both deafness and autism can be genetic.
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