Pseudohypertrophy is muscle enlargement due to vaccum proliferation, which is associated with functional losses. Most pseudohypertrophies occur in the context of overriding muscular diseases. The therapy corresponds above all to a movement therapy to restore full mobility.
What is pseudohypertrophy?
The group of diseases of muscle hypertrophy includes diseases characterized by a pathological increase in muscle tissue after overexertion. A similar phenomenon occurs in pseudohypertrophy. This is an enlargement of a skeletal muscle that is macroscopically visible. Simultaneously with the enlargement there are functional losses. See whicheverhealth for Stage Fright Meanings.
The patient loses strength in the affected muscle. The differentiation from muscle hypertrophy is histological. In pseudohypertrophy, the interstitial connective tissue proliferates. This is the connective tissue between the parenchymal cells of the muscles. In the case of hypertrophy, the connective tissue does not increase, but rather the parenchymal cells enlarge and thus cause organ enlargement.
Also, the causes of hypertrophy and pseudohypertrophy are not the same. Ultimately, pseudohypertrophy is often causally preceded by muscle hypertrophy, for example. In this case, pseudohypertrophy is a symptom of hypertrophy. The combination of pseudohypertrophy and hypertrophy primarily characterizes some groups of genetic diseases.
The cause of the enlarged muscle in the context of pseudohypertrophy is an overgrowth of vacancies. This is the proliferation of connective tissue or fatty tissue that takes place in a space in the human body that has become free. Vakat proliferations are therefore adaptation reactions of human cells and tissues.
The space for the growths is usually free in the context of atrophy. This previous muscular atrophy can take place in the context of neuromuscular diseases. Thus, the primary cause of pseudohypertrophies is often a primary disease such as Duchenne muscular dystrophy with a predilection site in the calf muscles. If a primary disease such as Duchenne muscular atrophy causes the pseudohypertrophy, genetic factors usually play a role.
The atrophy in this disease is caused, for example, by a mutation in the dystrophin gene. Pseudohypertrophies based on genetic mutations can also occur in the context of limb -girdle dystrophies. The same applies to primary diseases with a neurologically caused change in the muscle tissue. In short, the primary cause of pseudohypertrophy corresponds to the primary cause of each primary disease.
Symptoms, Ailments & Signs
Patients with pseudohypertrophy suffer from an increase in muscle volume, which is caused by fatty tissue storage or as part of connective tissue remodeling within the muscles. This phenomenon leads to functional losses in the affected muscle. Since, unlike hypertrophy, the muscle cells do not enlarge, pseudohypertrophy is associated with muscle weakness in most cases.
Depending on the location of the pseudohypertrophy, patients may suffer from gait disturbances due to muscle weakness, for example . When muscles of the upper extremities are affected by pseudohypertrophy, these disorders often also manifest themselves as an inability to hold a firm grip or a general clumsiness. Depending on the primary disease, other symptoms may also appear.
A pseudohypertrophy in the context of the muscular dystrophies of the Becker-Kiener or Duchenne type, the pseudohypertrophy is usually in the area of the calves and symptomatically causes so-called gnome calves. In the case of myotilinopathies such as the limb-girdle dystrophies LGMD1A, speech disorders can accompany the symptoms. Pseudohypertrophies in the heart muscle are usually due to cardiomyopathies. These pseudohypertrophies are usually preceded by a heart attack.
Diagnosis & course of disease
To diagnose pseudohypertrophy, the doctor first performs imaging tests. These methods primarily include computed tomography, nuclear spin tomography and ultrasound. In order to rule out neurological factors as the cause of muscle weakness, magnetic resonance imaging is usually the most helpful tool.
Pseudohypertrophy must be differentiated from true hypertrophy in diagnostics. This differential diagnosis is usually made by means of microscopic examinations of muscle tissue, which is removed in a muscle biopsy. Since hypertrophy and pseudohypertrophy are associated with the proliferation of different types of tissue, the distinction between the two phenomena can be made using histology after the biopsy.
In most cases, the doctor also tries to clarify the primary cause during the diagnosis. Genetic primary diseases can be confirmed or ruled out, for example, within the framework of molecular genetic analyses.
Due to the pseudohypertrophy, those affected suffer from a significant increase in muscles. However, this increase has a very negative effect on everyday life and also on the movement of the patient and can lead to restricted movement or gait disorders. Muscle weakness is also not uncommon due to pseudohypertrophy and makes everyday life considerably more difficult for those affected.
The pseudohypertrophy also affects the face, which can lead to speech disorders. The development of children is significantly restricted and negatively influenced by this disease. Pseudohypertrophy can also have a negative effect on the heart of the affected person, so that in the worst case a heart attack can occur. Unfortunately, this disease cannot be treated causally.
For this reason, the treatment of pseudohypertrophy is primarily aimed at reducing muscle weakness. In some cases, however, those affected are dependent on the help of other people in their everyday lives. Psychological treatment is also necessary in many cases. It cannot be universally predicted whether pseudohypertrophy will lead to a reduction in life expectancy.
When should you go to the doctor?
Decreased physical performance should be presented to a doctor. If the general muscle strength decreases, a follow-up visit is recommended so that the cause can be clarified and a treatment plan can be drawn up. A doctor should be consulted if there are restrictions on mobility, problems with locomotion or if you can no longer carry out your usual sporting activities.
A doctor is required in the event of unsteady gait, swelling on the body or incomprehensible growths. Deposits of fatty tissue, deformations or changes in the muscles must be examined. If the sufferer gains weight or size for no apparent reason, there is cause for concern. A visit to the doctor is necessary because, if left untreated, pseudohypertrophy has a progressive course of the disease.
Speech disorders are to be understood as an alarm signal from the organism. They should be examined and clarified as soon as possible. A general malaise, a feeling of illness or inner weakness should be presented to a doctor. If objects of everyday use can no longer be held or if the hand cannot form a firm grip, a doctor should be consulted.
Irregular heart rhythms, heart palpitations or changes in blood pressure are indications of a health impairment. Since there is a risk of a heart attack and thus a health emergency, a doctor must be consulted immediately. If you have trouble sleeping or if you tire quickly, you should also see a doctor.
Treatment & Therapy
In most cases, no causal therapies are available for the treatment of pseudohypertrophy. This is especially true when the phenomenon occurs in the context of genetic mutations. Gene therapies are not yet a therapy option and will remain a subject of medical research for the time being. Pseudohypertrophy in these diseases can only be treated symptomatically.
The aim of this treatment is primarily to reduce muscle weakness. Improving and maintaining independence and mobility is intended to ensure long-term self-sufficiency and the ability to participate in social life. Treatment for this purpose is usually carried out by an interdisciplinary team consisting of nurses, physiotherapists, occupational therapists, psychologists and, if necessary, social workers.
The rehabilitation of the muscles promotes movement therapies with light to moderate loads. Walking, swimming and cycling can be on the program. The muscular endurance is improved and the performance of the cardiovascular system increases. For some primary diseases, drug therapy options are available in addition to exercise therapy measures.
A preventative measure for pseudohypertrophy may be regular exercise. Although there are no preventive measures available against certain primary diseases with pseudohypertrophy, the muscle weakness of pseudohypertrophy can be kept at a moderate level through regular training.
In the case of pseudohypertrophy, those affected usually only have a few and only limited measures and options for aftercare. For this reason, patients should consult a doctor as soon as the first symptoms and signs of the disease appear, so that further complications can be prevented. As a rule, no independent healing can occur, so those affected are usually always dependent on medical examination and treatment.
The sooner a doctor is consulted, the better the further course of the disease. In most cases, treatment is carried out with the help of various surgical procedures, through which the tumors can be removed. After such an operation, those affected should rest and protect their bodies.
Physical exertion and stressful activities should be avoided. Regular check-ups by a doctor are also essential. This can prevent infection and inflammation. In many cases, the life expectancy of the patient is limited and reduced by the pseudohypertrophy. Further follow-up measures are usually not available to the patient.
You can do that yourself
People who suffer from pseudohypertrophy are usually prescribed movement therapy. It is particularly important to keep these therapy appointments, because the weakened muscle parts are strengthened again with targeted movement. With consistent adherence to therapy, there is a good chance of regaining the full strength, mobility and flexibility of the affected muscles.
If there are speech disorders due to the illness, the same applies to the prescribed logopedic treatment. Of course, the prescribed medication should also be taken consistently in accordance with the doctor’s instructions. The fact that the disease can usually only be treated symptomatically is a great burden for those affected. Accompanying psychotherapy is recommended here. This is especially true for patients who depend on the help of others.
Exercising in everyday life beyond the prescribed therapies also pays off. Patients should run, walk, swim, and/or cycle a lot. Regular exercise promotes the cardiovascular system as well as muscular endurance.
Regular tension should also be followed by regular relaxation. Many patients suffering from pseudohypertrophy tend to withdraw from society. This should be actively prevented, for example with periodic get-togethers with friends. Joining self-help groups is also useful. The DGM German Society for Muscle Diseases (www.dgm.org) provides the relevant contacts and further information.