Always tripping or spraining your ankles? It could be a genetic nerve disorder

Repeatedly tripping, spraining an ankle or missing a step may seem like ordinary clumsiness. But when those episodes come with numbness in the feet and lower legs, followed by weakness in the hands, they can point to Charcot-Marie-Tooth disease, or CMT.

CMT is an inherited neuropathy caused by genetic mutations affecting the peripheral nerves. Those nerves connect the brain and spinal cord with the rest of the body, allowing people to feel sensations and move their muscles. In CMT, mutations damage either the myelin sheath, which insulates the nerves, or the nerve fibres themselves.

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Many patients do not have significant pain or sensory symptoms

Dr Newman Cheng of Singapore’s National Neuroscience Institute said many patients do not experience major pain or sensory symptoms and often report a recent onset of weakness. Dr Amanda Chin Xin Yi of National University Hospital said damaged nerves transmit signals less effectively, leading to progressive muscle weakness, muscle wasting and sensory loss.

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a recent onset of weakness

The disease can appear at any age, from early childhood to late adulthood. Children may show delayed motor milestones, low muscle tone, toe walking or severe skeletal deformities such as scoliosis. Symptoms most commonly begin during adolescence or young adulthood, with gradual foot deformities, ankle weakness and difficulty walking. People who develop symptoms in childhood tend to have a more severe course because their nerves are affected for longer. Some adults do not develop symptoms until their 40s, 50s or later.

CMT’s slow progression can make its early signs easy to dismiss. The condition can eventually affect balance, walking, hand use and other daily activities, making persistent or worsening symptoms worth discussing with a doctor.

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nerve signals are transmitted less effectively, leading to progressive muscle weakness, muscle wasting and sensory loss