Spinal Muscular Atrophy - SMA
What is Spinal Muscular Atrophy?
Muscular Atrophy (SMA) is a motor neuron disease. The motor neurons
affect the voluntary muscles that are used for activities such as
crawling, walking, head and neck control, and swallowing. It is a
relatively common "rare disorder": approximately 1 in 6000 babies
born are affected, and about 1 in 40 people are genetic carriers.
SMA affects muscles throughout the body, although the proximal
muscles (those closest to the trunk of one’s body - i.e. shoulders,
hips, and back) are often most severely affected. Weakness in the
legs is generally greater than in the arms. Sometimes feeding and
swallowing can be affected. Involvement of respiratory muscles
(muscles involved in breathing and coughing) can lead to an
increased tendency for pneumonia and other lung problems. Sensation
and the ability to feel are not affected. Intellectual activity is
normal and it is often observed that patients with SMA are unusually
bright and sociable. Patients are generally grouped into one of four
categories, based on certain key motor function milestones.
SMA is an autosomal recessive genetic disease. In order for a child to be affected by SMA, both parents must be carriers of the abnormal gene and both must pass this gene on to their child. Although both parents are carriers the likelihood of a child inheriting the disorder is 25%, or 1 in 4. An individual with SMA has a missing or mutated gene (SMN1, or survival motor neuron 1) that produces a protein in the body called Survival Motor Neuron (SMN) protein. This protein deficiency has its most severe affect on motor neurons. Motor neurons are nerve cells in the spinal cord which send out nerve fibers to muscles throughout the body. Since SMN protein is critical to the survival and health of motor neurons, without this protein nerve cells may atrophy, shrink and eventually die, resulting in muscle weakness. As a child with SMA grows their bodies are doubly stressed, first by the decrease in motor neurons and then by the increased demands on the nerve and muscle cells as their bodies grow larger. The resulting muscle atrophy can cause weakness and bone and spinal deformities that may lead to further loss of function, as well as additional compromise of the respiratory (breathing) system. There are four types of SMA, SMA Type I, II, III, IV. The determination of the type of SMA is based upon the physical milestones achieved. It is important to note that the course of the disease may be different for each child.