The deep tendon reflex is also lost in patients with DSMA1.Uterine growth retardation and poor foetal movement have been observed in severe DSMA1 cases. Causes
DSMA1 is caused by a genetic mutation in the IGHMBP2 gene (located on chromosome 11, locus 11q13.3), which codes the immunoglobulin helicase μ-binding protein 2. The role of the IGHMBP2 protein is not fully understood, but it is known to affect mRNA processing. The cellular mechanisms of the mutation, as well as the protein mechanisms disrupted by the mutation, are unknown. IGHMBP2 mutations are usually random mutations which are normally not passed down through generations. Pathophysiology
The pathology underlying the observable characteristics of DSMA1 is cell body degeneration of motor nerves. Specifically, the anterior horn α-motorneurons degenerate within the first six months of life leading to a variety of symptoms. Muscle deterioration increases at around 1–2 years of age, resulting in reduced motor function. The most severely affected muscles include facial muscles and the tongue (which may develop a twitch due to hypoglossal nerve paralysis). Reduced pain sensation and excessive sweating are sometimes observed. Non-ambulant patients may develop pressure ulcers, severe constipation, urinary incontinence, and (rarely) reflux nephropathy in the advanced stages of the disease. Diagnosis
The diagnosis for DMSA1 is usually masked by a diagnosis for a respiratory disorder. In infants, DMSAI is usually the cause of acute respiratory insufficiency in the first 6 months of life. The respiratory distress should be confirmed as diaphragmatic palsy by fluoroscopy or by electromyography.
In addition to being an antifungal, butenafine is an anti inflammatory. Because fungal skin infections are often accompanied by significant inflammation, this is a desirable property. The fact that butenafine has intrinsic anti inflammatory properties is also desirable since  it is not necessary to add cortical steroids (which decrease the ability to fight infection) to reduce inflammation. Chemistry
Butenafine hydrochloride is an odorless white crystalline powder that is freely soluble in methanol, ethanol, and chloroform, and slightly soluble in water. == References ==