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Daniel B. Drachman, MD; Leslie P. Weiner, MD; Donald L. Price, MD

Arch Neurol. 1976;33(5):362-367.

Abstract
• Immobilization of the embryo has been postulated to cause the joint deformities in arthrogryposis multiplex congenita (AMC). Experimental damage to the motor neurons or pharmacologic blockade of neuromuscular transmission has previously resulted in typical joint changes of AMC. In the present investigation, we have studied the effects of paralysis produced by a viral myopathy on joint development.

Coxsackievirus A2 was injected intravenously into chick embryos on the seventh day of incubation. Within 48 hours, severe myositis and paralysis resulted. Electron microscopical and immunofluorescence techniques demonstrated virus in muscle cells. Within three to four days after infection, the muscle had virtually disappeared. Ankylosis of joints, corresponding to that seen in human AMC, occurred. This study shows that primary myopathy with paralysis can produce arthrogrypotic joint deformities. The possibility of a viral etiologic factor in some human cases of AMC should be considered.

Author Affiliations
Janis Chase

From the Department of Neurology, laboratories of neuromuscular diseases, neurovirology, and neuropathology, Johns Hopkins University School of Medicine, Baltimore.

Footnotes
Accepted for publication June 17, 1975.

Reprint requests to Department of Neurology, 317 Traylor Bldg, 1721 E Madison St, Baltimore, MD 21205 (Dr Drachman).

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