In Charcot-Marie-Tooth disease, early weakness typically begins in which region?

In Charcot-Marie-Tooth disease, early weakness typically begins in which region?

• A. Upper legs
• B. Lower legs
• C. Hands
• D. Facial muscles

Answer: (B)

Charcot-Marie-Tooth disease is a hereditary neuropathy that affects nerves in a length-dependent way, meaning the longest nerves are damaged first. The nerves controlling the muscles of the lower legs and feet are among the longest, so weakness typically begins there. Clinically, you often see early difficulty with ankle dorsiflexion (foot drop), calf muscle wasting, and high arches (pes cavus) due to imbalance from distal muscle weakness. Sensory loss for the feet may also start in the distal parts of the legs. The hands and facial muscles tend to be spared early and are affected later as the disease progresses. So the region where weakness most commonly starts is the lower legs.

Charcot-Marie-Tooth disease is a hereditary neuropathy that affects nerves in a length-dependent way, meaning the longest nerves are damaged first. The nerves controlling the muscles of the lower legs and feet are among the longest, so weakness typically begins there. Clinically, you often see early difficulty with ankle dorsiflexion (foot drop), calf muscle wasting, and high arches (pes cavus) due to imbalance from distal muscle weakness. Sensory loss for the feet may also start in the distal parts of the legs. The hands and facial muscles tend to be spared early and are affected later as the disease progresses. So the region where weakness most commonly starts is the lower legs.