RYR1 and congenital myopathy: It is also important to mention that primary myopathies may go along with secondary transmission disease, which does not represent CMS, such as in patients with congenital myopathy due to TPM2 mutations [126], or patients carrying mutations in KLHL40, BIN1, DNM2, MTM1, TPM3, or RYR1. Importantly, secondary transmission disease frequently responds beneficially to AchEI.