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Living with Charcot-Marie-Tooth disease type 4E

An inherited nerve condition present from early infancy with low muscle tone and very slow nerve signals.

Understanding Charcot-Marie-Tooth disease type 4E

Charcot-Marie-Tooth disease type 4E (CMT4E) is a congenital subtype of Charcot-Marie-Tooth type 4 in which the nerve coating (myelin) is underdeveloped.

It looks like Dejerine-Sottas syndrome, with low muscle tone or delayed motor skills in infancy and extremely slow nerve signals. Breathing problems and cranial nerve involvement are possible. Typical features are weakness and wasting in the muscles farthest from the center of the body, loss of feeling, and foot differences.

Signs & symptoms

GARD doesn't list a separate symptom list for this condition. Its summary describes these features:

  • Low muscle tone (hypotonia) in infancy
  • Delayed motor skills
  • Weakness in the hands and feet
  • Muscle wasting
  • Loss of feeling
  • Foot differences

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include brain and nervous system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in EGR2 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    Hereditary Neuropathy Foundation Inc., Charcot-Marie-Tooth Association and Muscular Dystrophy Association may keep lists of experts for this condition.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Expert lists: Hereditary Neuropathy Foundation Inc., Charcot-Marie-Tooth Association, Muscular Dystrophy Association
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Hereditary Neuropathy Foundation Inc. and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Can EGR2 genetic testing confirm the diagnosis?
Should my child's breathing be monitored?
What therapy can help with motor skills?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive
GenesEGR2

Changes in the EGR2 gene cause this condition. It is inherited in an autosomal recessive way, so a child inherits a changed copy of the gene from each parent.

GeneticNeurological

Also known as: autosomal recessive congenital hypomyelinating neuropathy; autosomal recessive congenital hypomyelinating or amyelinating neuropathy; charcot-marie-tooth disease, demyelinating, type 4e; charcot-marie-tooth neuropathy type 4e; chn1; cmt4e

Patient organizations

Source: NIH GARD · Charcot-Marie-Tooth disease type 4EGARD ID 9203 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Charcot-Marie-Tooth disease type 4E.

Explore the Charcot-Marie-Tooth disease type 4E blog

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Explore actively recruiting Charcot-Marie-Tooth disease type 4E studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Charcot-Marie-Tooth disease type 4E with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
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  • Eligibility is confirmed by the study team

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