Lower Extremity Lymphatic Function in Nonambulatory Patients with Neuromuscular Disease

Lymphedema results from inadequate lymphatic function causing swelling in subcutaneous tissues. Lymph is transported proximally through valved lymphatic channels and muscle contraction. The purpose of this study was to determine lymphatic function in nonambulatory patients with lower extremity neuromuscular disease. Our Lymphedema Program database of 700 patients was reviewed for nonambulatory patients with lower extremity neuromuscular disease. Patient age, gender, disease, body mass index (BMI), and lymphoscintigram result were recorded. Eight patients were included in the study: myelomeningocele (n = 6), spinal muscle atrophy type 2 (n = 1), Charcot Marie Tooth (n = 1). Patient ages were between 15 and 36 years; five were female. BMI range for patients without swelling or a normal lymphoscintigram (n = 4) was 22-27. Four subjects with lymphatic dysfunction by lymphoscintigram all were obese (BMI 36-74; p = 0.03). Nonambulatory patients with lower extremity neuromuscular dysfunction and swelling can exhibit normal lymphatic function. Obesity is associated with abnormal lymphoscintigram result and lymphedema in this patient population. Individuals should be advised to maintain a normal BMI.