Disease severity varies greatly, even between family members with identical mutations. Age of onset is highly variable, although symptoms usually appear between 8 and 15 years of age. Patients usually lose the ability to ambulate 10 – 20 years after symptoms appear. Milder forms present with symptoms other than weakness, such as muscle aches, cramps, or exercise intolerance, and people in this group can retain ambulation beyond age 60. Weakness is symmetric, progressive, and proximal (on or close to the torso), usually affecting the hip girdle and shoulder girdle muscles. Hip weakness can manifest as a waddling gate. Shoulder weakness can manifest as winged scapulas. Muscle contractures, especially of the Achilles tendon, and scoliosis can also occur. Heart function and intelligence are generally not affected. Additionally, the muscles of the face, eye, tongue, and neck are spared. Subtypes Three subtypes of the autosomal recessive form have been described * Pelvifemoral (Leyden-Möbius) LGMD: Weakness is first apparent in the pelvic girdle, and later in the shoulder girdle. Onset is early. It is the most frequent subtype. * Scapulohumeral (Erb) LGMD: Weakness is first apparent the shoulder girdle, and later in the pelvic girdle. Onset is later, and symptoms are milder. * HyperCKemia: No symptoms, although serum creatine kinase levels are high. There is a less common, autosomal dominant form, which is milder than the autosomal recessive forms, ranging from no symptoms to wheel chair dependence after age 60.
Calpainopathy
Complex regional pain syndrome
Median nerve palsy
Enthesopathy
Ulnar neuropathy
Sciatica
Carpal tunnel syndrome
Nerve compression syndrome