Spinal muscular atrophy (SMA) is a genetic condition that causes muscle weakness and atrophy (when muscles get smaller). The disease often starts in the muscles of the back, making it hard for children to stand up and walk. It can begin to affect other parts of the body too, causing other muscles to grow weak and shrink. At Nemours, our neurologists and other specialists provide expert care for kids with spinal muscular atrophy.
Spinal Muscular Atrophy (SMA)
Leaders in Life-Changing Care & Research
We’re also involved in innovative research that’s led to a true breakthrough in SMA treatment. Nemours Children's Hospital in Orlando was one of only four locations in the world to participate in a landmark study — the first targeted drug trial for SMA. Research showed that a new treatment can slow the effects of SMA, improve kids’ survival and, in some cases, remarkably improve their muscle function. So, some children with SMA type 1 who may have struggled to move around before may now have the hope of sitting, rolling over and standing.
SMA Types We Treat
There are four types of SMA that are based on how severe the symptoms are and when they begin. Generally, the longer it takes for symptoms to show, the less severe the disease will be.
- SMA type 1 (also called “Werdnig-Hoffmann disease”) is the most severe, with symptoms starting between birth and 6 months of age.
- SMA type 2 (also called “chronic infantile SMA”) has more moderate symptoms, which start at 6 to 18 months old. Infants can sit but not walk.
- SMA type 3 (also called “Kugelberg Welander disease” or “juvenile spinal muscular atrophy”) has the mildest symptoms, which can start between 18 months and the teen years. Children can walk, but they may fall a lot and may have weak arms and legs.
- SMA type 4 develops more slowly, with symptoms usually starting after age 35.
SMA Services We Offer
We offer a complete range of diagnostic and treatment options for children with spinal muscular atrophy. Our services, which may vary depending on the location you visit and the doctor your child sees, may include expert team care in:
- neurology leading the team for expert assessment and treatment
- orthopedic surgery for scoliosis (a curved spine), which can happen in some kids with SMA if their back muscles are weak
- pulmonology and respiratory therapy — to help treat breathing problems and prevent lung infections
- physical medicine and rehabilitation medicine — to help treat muscle function
- genetic testing — to look for a deletion or difference in the gene (SMN1) that causes SMA
- gastroenterology — to help with digestive issues
- pain management — to help manage any pain
- physical therapy and occupational therapy — to help kids maintain their muscle function
- nutrition — to make sure your child gets proper nutrition, including using feeding tubes, if needed
- psychology — to help kids cope
- speech and language therapy — to help with any speech problems
- orthotic services, including bracing — to help kids move
- assistive technology experts — to help with mobility and function
We work together to give your child coordinated treatment to make it easier for you to see multiple specialists in a single visit.
Why Choose Us for SMA
Until recently, there was no truly effective treatment option for the most severe form of SMA (SMA type 1). But in 2016, researchers had a breakthrough — allowing some kids to live longer and reach more developmental milestones. Nemours was at the forefront of the science that led to this discovery. A medication called Nusinersen (or Spinraza™) increases the amount of protein the body needs from a missing gene. And that means improvement in kids’ breathing, motor function and survival.
From diagnosis through treatment, at Nemours we’re dedicated to giving all kids with spinal muscular atrophy not just better care, but better lives.
Regional SMA Highlights
Services, programs and care teams differ at each location. Call for details.
We offer complete SMA care for kids at Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.).
- the only muscular dystrophy program of its kind in Delaware, certified and approved by the Muscular Dystrophy Association (MDA)
- Muscle Respiratory Care Clinic to help with breathing problems that can happen in kids with neuromuscular disorders like SMA
- advanced devices developed by our researchers, like the Wilmington Robotic EXoskeleton (WREX), which helps kids with weak muscles move their arms
- gait and motion analysis — precise, computer-aided camera tracking of body movements to help diagnose problems and figure out the best treatments
- academic medical center, where our experts teach the next generation of specialists
- Ronald McDonald House of Delaware , right across from our campus, for an affordable home away from home during long hospital stays
We offer complete SMA care for kids at Nemours Children’s Hospital (Orlando).
- some of the most accomplished pediatric SMA specialists in the world
- groundbreaking new SMA treatments being tested in clinical trials — one of only a handful of locations in the world approved for participation in these studies
- SMA program approved and supported by the SMA Foundation and Muscular Dystrophy Association (MDA)
- part of the Pediatric Neuromuscular Clinical Research Network for SMA, sponsored by the SMA Foundation
- works with other SMA experts at participating medical institutions and experts in Europe through SMA Europe , SMA REACH UK and TREAT-NMD
- one of the only pediatric pain management programs in the country, helping kids with acute (temporary) or chronic (ongoing) pain
- Ronald McDonald House on campus, for an affordable home away from home during long hospital stays
- Nemours SMA specialists available to provide pediatric consultation in the Wolfson emergency department if your child ever needs it
- advanced imaging testing at the Walter and Michelle Stys Neuroscience Institute , at Wolfson Children’s Hospital
- close academic and clinical ties with the University of Florida College of Medicine–Jacksonville and Mayo Clinic Florida , to give residents training about the special challenges of treating kids with neuromuscular disorders like SMA
- Ronald McDonald House across the street, for an affordable home away from home during long hospital stays