Becker Muscular Dystrophy (BMD) in Children
Muscular dystrophy (MD) is an
inherited (genetic) disorder of the muscles. It is called a neuromuscular disease.
are several types. Becker muscular dystrophy (BMD) is a rare type. It usually has
symptoms and occurs later than Duchenne muscular dystrophy (DMD), which is more common.
BMD causes weakness of skeletal muscles, breathing muscles, and the heart muscle.
time, the muscle fibers break down. Although skeletal muscle involvement is generally
less severe than in DMD, heart involvement is often more of a problem with BMD.
BMD is a genetic disease. This
means it passes from parents to children. It is caused by a faulty gene on the X
chromosome. It mostly affects boys. Girls are only carriers and usually don’t have
People normally have 23 pairs of
chromosomes in each cell of their body. One set of 23 chromosomes comes from the mother,
and one set of 23 chromosomes comes from the father. Each chromosome contains many
genes. One of these pairs of chromosomes controls a person’s sex. If this pair is
chromosomes (XX), then the child is a female. If this pair is one X and one Y chromosome
(XY), then the child is a male.
The faulty BMD gene is an X-linked
recessive gene. This means the gene needs to be on each of her two X chromosomes for
symptoms of the disease to occur in girls. She would need to inherit the faulty gene
from both her mother and her father. If she has only one faulty gene on one X
chromosome, she is a carrier of the disease but will likely not have symptoms. Boys
only one X chromosome, so if their X chromosome has a faulty gene, they will have
Children are more at risk for BMD
if they have a family member with the disease. Girls are rarely affected by this type
Symptoms usually start during the
teen or early adult years. They can include:
- Muscle cramping and feeling weak when
- Trouble walking, running, jumping,
- Falling often
- Muscle pain
- Enlarged calves
- Walking on tips of toes
- Weakness in arms and shoulders
- Difficulty breathing, especially with heart involvement
The symptoms of BMD can be like
other health conditions. Make sure your child sees their healthcare provider for
The healthcare provider will ask
about your child’s symptoms and health history. They may also ask about your family’s
health history to find out if other family members have had muscular dystrophy. They
will give your child a physical exam. Your child may also have tests, such as:
Blood tests. These may include genetic blood tests. Some
genetic tests can be done with saliva and don't need blood tests.
Electromyogram (EMG) and nerve conduction studies. These
tests check if muscle weakness is a result of muscle or nerve damage.
Muscle biopsy. A small sample of muscle tissue is taken
and looked at under a microscope.
Electrocardiogram (ECG). This is a test that records the
electrical activity of the heart. It shows abnormal rhythms (arrhythmias) and detects
heart muscle damage.
Echocardiogram. This is an
ultrasound test of the heart muscle. It shows a picture of how strong the heart
muscle is pumping.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
There is no known cure for BMD or
treatment to stop the muscles from weakening. The goal of treatment is to keep muscles
as strong as possible to allow a child to function independently. Treatment almost
always includes several kinds of specialists. It also includes testing over time,
as imaging, EMG, and heart and pulmonary studies.
Treatment choices include:
- Physical therapy to strengthen muscle and help prevent muscle contractures
- Braces and splints
- The use of steroid medicines, though
they can have unwanted side effects
- Surgery to treat contractures
- Medicines for heart disease, bone
disease, and respiratory disease when they occur
- Medicines from clinical research trials
- Wheelchair use
- Nutritional counseling
- Psychological counseling
Talk with your child’s healthcare providers about the risks, benefits, and possible
side effects of all treatments.
Children with BMD may have additional health problems, such as:
- Heart muscle weakening and not pumping
blood well (dilated cardiomyopathy)
- Breathing and lung problems
- Scoliosis, a sideways curving of the
back bones (vertebrae)
- Diet, nutrition, and digestive
- Trouble focusing, learning, or
- Complications from anesthesia, for which special care is
Your healthcare provider may advise
genetic counseling. You can discuss with a counselor the risk for BMD in a future
BMD is a condition that gets worse
over time (progressive). It needs lifelong management. Walking and sitting often become
more difficult as a child grows. In time, some will eventually need a wheelchair.
is because the leg muscles become too weak to work. Often, those with BMD can continue
to walk for many years. In some cases, a child may need a wheelchair earlier.
Your child will also need a heart
imaging test every 1 to 2 years. This may be a heart echocardiogram or MRI. These
look at the function and health of the heart. A child with BMD will need special care
during surgery to prevent problems from anesthesia.
People with BMD usually live until
their 40s. Problems from cardiomyopathy are a common cause of death.
A healthcare team will work with
your family to improve your child's function and give support as you learn to care
your child's needs.
You can contact the Muscular
Dystrophy Association (
www.mda.org) for support, resources, and help.
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Symptoms that don’t get better or get
- New symptoms
- Becker muscular dystrophy (BMD) is a
rare inherited disorder of the muscles.
- BMD causes weakness of skeletal muscles, breathing muscles, and the heart muscle.
Over time, the muscles may become too tight and pull together painfully.
- Children are more at risk for BMD if
they have a family member with the disease. Girls are rarely affected.
- There is no known cure for BMD or
treatment to stop the muscles from weakening. The goal of treatment is to keep
muscles as strong as possible to allow a child to function independently.
- Your healthcare provider may advise
genetic counseling. You can discuss with a counselor the risk of BMD in a future
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours, and on weekends and holidays. This is important if your
child becomes ill and you have questions or need advice.