Dystrophia Myotonica with Hypercapnic Respiratory Failure – Local Challenges and Ethical Dilemmas

Dystrophia myotonica type 1 (DM1) is an adult-onset progressive form of muscular dystrophy which eventually lead to respiratory failure. Non-invasive home mechanical ventilation (HMV) for these patients could result in a reduced risk of morbidity and mortality. The following case report describes the management of respiratory failure in a patient with DM, and the challenges that come with itespecially in our Malaysian settings.