In congenital muscular dystrophy, when do symptoms typically present and what brain findings may accompany them?

• A. In adolescence with sensory loss
• B. In late adulthood with cranial nerve palsy
• C. At birth or early infancy with hypotonia and brain involvement
• D. Only with isolated distal weakness

Answer: (C)

Concerning congenital muscular dystrophy, the onset is from birth or in the first months of life, with marked hypotonia and generalized weakness. This early presentation reflects the congenital nature of the disease, and many forms also involve the brain, so imaging or clinical signs can show CNS abnormalities such as brain malformations or white matter changes. That’s why the best choice describes symptoms appearing at birth or early infancy with hypotonia and brain involvement. The other scenarios—onset in adolescence or late adulthood, or weakness limited to distal muscles without brain findings—don’t fit the typical congenital pattern with CNS involvement.