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Spinal muscular atrophy (SMA) destroys the nerves responsible for controlling voluntary muscle movement, but does not affect intelligence. Muscles that control breathing, swallowing, head and neck control, walking, and crawling are the most severely affected. Symptoms most often appear before a baby is two years old, but can start before birth or not until adulthood. Over 60% of individuals who are diagnosed with SMA are severely affected. View testing options