In Duchenne muscular dystrophy, weakness is typically which of the following?

• A. Asymmetrical
• B. Neither
• C. Symmetrical
• D. Both

Answer: (C)

Duchenne muscular dystrophy causes symmetric proximal weakness. The underlying defect—loss of dystrophin—affects all skeletal muscles, so both sides of the body are involved in a similar way, starting with the proximal muscles of the pelvis and shoulders. This leads to a pattern where weakness appears on both limbs roughly equally, with a characteristic gait and the Gowers maneuver as proximal muscles weaken. As the disease progresses, distal muscles are affected later, but the early and predominant presentation is bilateral, symmetrical weakness. This contrasts with conditions that produce uneven or unilateral weakness, which are less typical for DMD.