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Genetic and metabolic medicine

Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease)

The commonest inherited neuropathy. Pes cavus, distal wasting and areflexia over decades, the 38 m/s nerve conduction cut-off between CMT1 and CMT2, PMP22 duplication testing first, telling CMT from CIDP, inheritance patterns, supportive care and the vincristine warning.

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At a glance

  • Charcot-Marie-Tooth disease (CMT, also called HMSN) is the commonest inherited neuropathy, about 1 in 2,500.
  • Slowly progressive, length-dependent motor and sensory neuropathy, starting in the first two decades. Life expectancy is normal.
  • Classified by nerve conduction velocity (CMT1 demyelinating, CMT2 axonal, intermediate) and then by gene. Over 100 genes are known, but four account for about 90% of genetically confirmed cases: PMP22, GJB1, MPZ and MFN2.

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Last updated
14 November 2026
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