As peripheral nerve damage progresses, the small muscles of the hands can become weaker and smaller.

This may become visible as wasting around parts of the hand, particularly the muscles responsible for fine movements.

When combined with progressive weakness in the feet, sensory changes, and a family history of similar problems, hand muscle wasting may be an important clue for a neurologist.

10. Unusual Walking Pattern

CMT can gradually change the way a person walks.

Someone may develop:

• A high-stepping gait
• Difficulty lifting the feet
• Reduced ankle control
• An unstable walking pattern
• Difficulty walking for long periods

The combination of foot weakness, foot deformities, and sensory loss can make walking increasingly demanding. Some people eventually use supportive devices such as ankle-foot orthoses, canes, or other mobility aids.

11. Muscle Cramps, Pain, or Fatigue

Although CMT is often described primarily in terms of weakness and sensory loss, some people experience pain.

Pain may result from nerve damage, muscle problems, abnormal posture, or strain caused by changes in walking mechanics.

Fatigue can also occur because weakened muscles require more effort to perform everyday movements. Persistent pain or unexplained muscle fatigue should be discussed with a healthcare professional rather than automatically assumed to be CMT.

12. A Family History of Similar Symptoms

Because CMT is hereditary, a family history can provide an important clue.

You may discover that a parent, sibling, grandparent, aunt, uncle, or child has experienced similar problems, such as:

• High arches
• Frequent tripping
• Foot drop
• Weak ankles
• Thin lower legs
• Difficulty walking
• Hand weakness

However, the absence of a known family history does not rule out CMT. A genetic change can sometimes appear in a family without being recognized previously, and different inheritance patterns exist.

Other Possible Symptoms

The 12 signs above are among the more recognizable features, but CMT can have additional manifestations.

Some people may develop tremor, scoliosis, or—in less common cases—problems involving speech, swallowing, or breathing. Certain genetic forms can also be associated with hearing problems or other neurological features.

This variation is one reason CMT can sometimes be difficult to recognize.

When Should You See a Doctor?

See more on the next page