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Charcot Marie Tooth Disease

What is Charcot Marie Tooth Disease?

Charcot Marie Tooth Disease (CMT)  is an umbrella term for a group of disorders characterised by similar symptoms. It is a relatively common disorder, affecting approximately 1 in every 2 500 persons worldwide. Charcot Marie Tooth Disease is a hereditary motor sensory neuropathy.  In layman’s terms, this is a condition that causes the breakdown of nerves which is passed on through your genes. CMT affects the muscles in the furthermost parts of the foot and lower leg through a progressive degeneration. Later stages can also affect the muscles of the hands and arms.

Due to the inheritable nature of CMT, most patients report a family histroy of the condition. This being the case, the severity of the condition is widely varied, even amongst family members. Initially the condition will present with a change to toe shape or positioning, such as increased clawing. The patient may experience some weakness in their lower legs, and feel more unsteady on their feet. Due to the muscular imbalance in the foot and lower legs, a high arched, or cavus foot, develops. As the condition develops the muscles in the lower leg continue to waste away. This results in the appearance of an upside down champagne bottle. Sensation in the feet will begin to decrease and ultimately the legs and feet will become completely numb.

Management of Charcot Marie Tooth Disease

Podiatrists can assist patient’s suffering from CMT in on of two ways.

First, through footwear and orthotic management. Muscle wastage causes an imbalance for the muscles in the foot. CMT sufferers often exhibit a foot drop and a tendency to load the outside of their foot. This predisposes them to instability and ankle sprains, as well as forefoot problems. The right footwear can assist in stabilising the foot. Orthotics can be designed to distribute the body weight evenly throughout the foot.

A loss of sensation in the foot can predispose the patient to injury as they cannot feel if the foot is damaged. Regular visual foot checks are important to ensure a potential injury is addressed. Podiatrists can help with managing nail and callus care as well, as the patient may be at risk of causing further damage if self-treating.