Type 1 SMA (young babies)
Children with type 1 SMA show symptoms in the first 6 months of life.
Babies with the condition:
- have very weak and floppy arms and legs (hypotonia)
- have problems moving, eating, breathing, and swallowing
- are unable to raise their head or sit without support
Most babies with type 1 SMA die during the first few years of life, usually as a result of serious breathing difficulties.
Spinal Muscular Atrophy UK has more information about type 1 SMA.
Type 2 SMA (older babies and toddlers)
Children with type 2 SMA usually show symptoms when they're 7 to 18 months old. The symptoms are less severe than type 1.
Children with the condition may:
- be able to sit up without help, but not stand or walk
- have weak arms or legs
- have shaking (tremors) in their fingers and hands
- later develop problems with their joints, such as an unusually curved spine (scoliosis)
- have weak breathing muscles and difficulty coughing – this can put them at risk of chest infections
Type 2 SMA can shorten life expectancy, but most children with it survive into adulthood and can have long, fulfilling lives.
Spinal Muscular Atrophy UK has more information about type 2 SMA.
Type 3 SMA (children and young adults)
People with type 3 SMA usually develop symptoms after 18 months of age, but this is very variable and sometimes it may not appear until late childhood or early adulthood.
People with the condition:
- are able to stand and walk without help, although they may find walking or getting up from a sitting position difficult
- may have balance problems, difficulty running or climbing steps, and a slight shaking in their fingers
- may find walking gets gradually harder over time, and they may eventually lose the ability to walk when they're older
Type 3 SMA does not usually affect life expectancy.
Spinal Muscular Atrophy UK has more information about type 3 SMA.
Type 4 SMA (adults)
Type 4 SMA, also called adult-onset SMA, usually begins in early adulthood.
Someone with the condition may have:
- weakness in the hands and feet
- difficulty walking
- shaking and twitching muscles
Type 4 SMA gets slowly worse over time, but does not normally cause problems with breathing or swallowing. It does not affect life expectancy.
Spinal Muscular Atrophy UK has more information about type 4 SMA.
Other types of SMA
There are several other types of SMA, including:
- spinal muscular atrophy with respiratory distress (SMARD) – a type of SMA that's usually diagnosed during a baby's first year of life and can cause serious breathing problems
- Kennedy's disease, or spinobulbar muscular atrophy (SBMA) – a rare type of SMA that only affects men and usually starts in middle age; it does not usually affect life expectancy
- distal spinal muscular atrophy (DSMA) – a type of SMA that mainly affects the hands, feet, lower arms, and lower legs