Neuromuscular conditions in children

Neuromuscular conditions affect the nerves that control the muscles, the junction between nerve and muscle, or the muscles themselves. They usually cause weakness, and some also cause tiredness, cramps or loss of skills. Many are genetic, and some can now be treated, so an accurate diagnosis matters.

The main groups

• Muscular dystrophies, such as Duchenne and Becker, and other myopathies (conditions of the muscle)
• Spinal muscular atrophy (SMA), which affects the nerve cells in the spinal cord that control the muscles
• Peripheral neuropathies, such as Charcot-Marie-Tooth disease
• Guillain-Barré syndrome, in which weakness, often with pain or tingling, comes on over days, usually after an infection. It needs urgent hospital assessment, and most children recover well
• Myasthenia gravis and congenital myasthenic syndromes, which affect the junction between nerve and muscle

Signs you may notice

• A floppy baby, or a weak cry or suck
• Late sitting, standing or walking
• Frequent falls, or difficulty running, climbing stairs or getting up from the floor
• Walking on tiptoes or with a waddling walk
• Weakness that gets worse with activity and better with rest, drooping eyelids or double vision
• Numbness, tingling, or weak ankles and feet
• Muscle cramps or pain with exercise

Tests

• A full examination of muscle strength, tone and reflexes
• Blood tests, such as creatine kinase (CK), a marker of muscle damage
• Genetic testing, which often confirms the diagnosis
• Nerve conduction studies and EMG, which test how nerves and muscles work
• Muscle MRI or, less often nowadays, a muscle biopsy
• Specific tests for myasthenia, such as antibody blood tests

Treatment and care

• Several conditions now have specific treatments, for example for SMA, Duchenne muscular dystrophy and myasthenia
• Physiotherapy to keep muscles and joints flexible, and splints or orthoses where helpful
• Regular checks of breathing, heart, spine and nutrition where needed
• Care shared with specialist neuromuscular centres in Cyprus and abroad
• Genetic counselling for the family

How you can help

• Keep your child active, within what feels comfortable
• Follow the stretching programme your physiotherapist suggests
• Tell the school about tiredness, and ask for PE to be adapted if needed
• Keep vaccinations up to date, including the yearly flu vaccine
• Film anything you are worried about and bring the video to your appointment

When to seek urgent help

Call 112 or go to the Emergency Department if your child:

• Has difficulty breathing, a weak cough, choking or difficulty swallowing
• Develops sudden or rapidly worsening weakness
• Has weakness spreading up from the legs over hours or days
• Has drooping eyelids, double vision or difficulty swallowing that is getting worse

Notes for your appointment

Write down what you notice and any questions, and bring this to your appointment.

Contact CPNI

Worried about your child’s strength or walking? Call our office on +357 22 476 627 to arrange an assessment, or email cpni2007@gmail.com. We see children through GeSY, and privately if they are not GeSY beneficiaries, in Nicosia and Limassol.

More leaflets and information: www.cpni.com.cy

This leaflet gives general information. It does not replace advice from your child's doctor.

Reviewed by Dr Paola Nicolaides, Consultant Paediatric Neurologist, November 2026.