Symptoms of CMT usually begin in late childhood or early adulthood, but in some people symptoms do not appear until their early thirties or forties, and the main features of the disease are deficits due to lower motor neuron damage, sensory signs and symptoms.
Weakness begins distally in the feet and progresses proximally in an ascending pattern. Neuropathic bone deformations develop, and Charcot-Marie-Tooth disease is characterized by a hanging foot (pes cavus) and clawed thumbs. As the disease progresses, arm muscle weakness may occur. In the early stage, the muscle reflexes in the ankle joint disappear, and the canine and patellar reflexes in the upper limbs disappear. Signs of sensory system dysfunction occur in about 70% patients and include loss of vibration and joint position sensation followed by decreased pain and temperature sensation in the hands, feet, and lower legs. Paresthesias can also occur, but they are less common than in other neuropathies. Restless legs syndrome occurs in almost 40% cases of CMT type 2
