Main clinical features
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adult-onset inherited neuromuscular disorder characterized by progressive ptosis, external ophthalmoplegia, and weakness of the masseter, facial, pharyngeal, and distal limb muscles
mean age of onset was 27.0 ± 7.2 years (ranging between 14 and 38 years; disease duration ranged from 1 to 24 years. Initial symptoms included muscle weakness of distal limb in ten individuals, ptosis in one individual, and weakness in closing eyes in one individual
presence of rimmed vacuoles (RVs) in the muscle fibers and myopathic changes of differing severity |