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Hi there Symptoms detailed below, further details can be found by visiting www.charcotmarietooth.webs.com Charcot-Marie-Tooth disease (or syndrome), also known as CMT or HMSN is a hereditary neuromuscular condition. Very early symptoms include general "clumsiness". Frequent tripping and falling can be an early sign. High arches (or very low arches) can be a symptom as can foot drop (the foot drooping due to lack of muscle tone in the feet). The high arches can lead to instability in the ankle and twisting of the ankles. An awkward walking gait can be noticed early on as the affected person lifts legs higher to compensate for the foot drop. Walking is often with a toe to heel movement rather than the usual heel to toe movement. Hammer toes (curled toes) can be a common symptom. As muscle tone is lost in the lower legs, the legs can take on the characteristic shape often described as an inverted champagne bottle. Some sensory loss and numbness is usual in both the arms and legs, but is rarely troublesome. Rarely, this numbness can be severe, and it is easy then for individuals to injure themselves without knowing it. Exceptionally cold hands and feet are also common, caused by poor circulation in the extremities. The hands and forearms tend to become affected as the disease progresses, and can lead to loss of fine motor control, dexterity and overall hand strength, making doing up buttons difficult and undoing jam-jars and bottles almost impossible. Pain is often a feature of CMT, and is usually a result of poor walking - an unbalanced foot and ankle leads to additional stress on the knees, hips, back and even shoulders and neck. More rarely, the damaged nerves themselves cause pain, known as neuropathic pain, which is much more of a problem to bring under control. It is also possible to have some tremor in both the arms and legs. Severe tremor and CMT can be known as the Roussy-Levy Syndrome. Cramps can also be an occurance. As the disease progresses, there can be increased difficulty in walking, and aids may be needed, such as orthoses (splints), walking sticks, and wheelchairs, although it is rare for someone with CMT to become a permanent wheelchair user. Many people use wheelchairs for occasional use, to relieve the pain and effort of walking. Very rarely the following symptoms can be noticed ... People with CMT can have a severe curve of the spine (scoliosis). Speech and swallowing difficulties are possible. The phrenic nerve which controls the diaphragm can also be affected in very rare cases, and this can lead to some breating difficulties, particularly when lying flat in bed at night. Sam Lewis Founder CMT Central www.charcotmarietooth.webs.com

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