1/8. S-1 radiculopathy as a possible predisposing factor in focal myositis with unilateral hypertrophy of the calf muscles.Associated with chronic S-1 radiculopathy, a 44-year-old man developed unilateral hypertrophy of the calf muscles. electromyography revealed neurogenic alterations in the corresponding limb compatible with S-1 radiculopathy. In addition, MR-tomographic and bioptic findings were consistent with a focal inflammatory myopathy of the enlarged right gastrocnemius muscle. Predisposing factors for the localisation of a focal myositis are unknown. This case report highlights the diagnostic difficulties in distinguishing focal myositis and denervation hypertrophy following S-1 radiculopathy or secondary inflammation related to denervation. We consider the possibility that in our case the inflammatory process might have been triggered by electromyographically proven chronic denervation related to radiculopathy.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
2/8. Muscle hypertrophy due to scarring of the S1 nerve root.Segmental muscle enlargement occurs in a variety of neurogenic conditions. We present a patient with calf hypertrophy, likely produced by continuous neuromuscular irritability and compensatory type 1 and type 2 muscle fiber hypertrophy. The underlying lesion of the S1 nerve root was caused by scarring, which could be demonstrated by Gadolinum enhanced, fat saturated magnetic resonance imaging. Thus, the application of this technique is recommended in otherwise etiologically unclear cases of neurogenic muscular lesions in order to detect chronic nerve root pathology.- - - - - - - - - - ranking = 1keywords = hypertrophy (Clic here for more details about this article) |
3/8. spinal canal stenosis at the level of axis.We describe a rare case of marked segmental stenosis of the axis secondary to developmental hypertrophy of the posterior neural arch causing severe neck pain and headache in the occipital region. The patient made a remarkable recovery following decompressive laminectomy and foraminal decompression.- - - - - - - - - - ranking = 0.16666666666667keywords = hypertrophy (Clic here for more details about this article) |
4/8. Unilateral calf hypertrophy seen in lumbosacral stenosis: case report and review of the literature.STUDY DESIGN: A case report of a patient with neurogenic unilateral calf hypertrophy and review of the literature are reported. OBJECTIVES: To provide further evidence that S1 radiculopathy is predisposed to develop neurogenic muscle hypertrophy. SUMMARY OF BACKGROUND DATA: Calf hypertrophy, specifically hypertrophy of the gastrocnemius muscle, is a rare but recognized presentation of S1 and less commonly L5 radiculopathies. The pathophysiology of this is incompletely understood. methods: We present a 59-year-old patient with painless progressive distal right leg weakness and calf enlargement. Electrodiagnostic studies and magnetic resonance imaging scanning were performed to evaluate the extent and cause of radicular damage as the etiology for unilateral calf hypertrophy. RESULTS: Examination and electrodiagnostic studies revealed right L5, right S1, and left L5 radiculopathies. Imaging studies demonstrated lumbar stenosis at L3-L4, L4-L5, and L5-S1 vertebral levels as well as L4-L5 and L5-S1 foraminal stenosis. After decompressive surgery the progressive nature of the patient's symptomatology halted, and he had partial resolution of his deficits. CONCLUSION: Although the patient had bilateral L5 radiculopathies, he only had hypertrophy in the distribution of his right S1 radiculopathy. This supports the hypothesis that dysfunction of the S1 nerve root or its distribution is a predisposing factor to develop neurogenic muscle hypertrophy. Furthermore, patients presenting with unilateral calf hypertrophy need a careful diagnostic evaluation for S1 radiculopathy as well as to exclude asymmetric presentation of systemic neuromuscular conditions.- - - - - - - - - - ranking = 2keywords = hypertrophy (Clic here for more details about this article) |
5/8. Focal myositis associated with S-1 radiculopathy: report of two cases.Two cases are described of pseudotumoral calf hypertrophy after laminectomy for a compressive S-1 radiculopathy. The serum creatine kinase (CK) level was normal or mildly elevated. T2-weighted magnetic resonance imaging (MRI) showed calf enlargement, with an increased signal of the medial head of the gastrocnemius muscle. electromyography revealed fibrillation potentials and positive sharp waves, but no complex repetitive discharges in the affected gastrocnemius muscle, with motor unit potentials having mixed neurogenic and myopathic features. Muscle biopsy revealed a focal myositis associated with some features of denervation. A brief course of corticosteroids was followed by remission clinically and improvement in the MRI findings.- - - - - - - - - - ranking = 0.16666666666667keywords = hypertrophy (Clic here for more details about this article) |
6/8. Muscle hypertrophy with complex repetitive discharges in C-6 radiculopathy.OBJECTIVE: To report on a case of post-denervation muscle hypertrophy in an unusual distribution. CASE REPORT: A 52-year-old patient with severe flaccid paraparesis after polio developed unilateral C-6 radiculopathy that resolved with conservative treatment. Within 2 years marked hypertrophy, stiffness and pain in the muscles in the affected myotome developed. EMG discovered abundant complex repetitive discharges (CRD) within hypertrophic muscles. On biopsy, true hypertrophy of muscle fibers and some group atrophy was found. Steroid treatment relieved the symptoms and significantly suppressed the CRD. The possible causative role of CRD for hypertrophy in partially denervated muscle is discussed.- - - - - - - - - - ranking = 1.3333333333333keywords = hypertrophy (Clic here for more details about this article) |
7/8. Pain and calf hypertrophy associated with spontaneous repetitive discharges treated with botulinum toxin.OBJECTIVE: To report a case of neurogenic calf hypertrophy associated with root lesion responsive to botulinum toxin (BTX). In addition, we systematically review the literature for cases of muscle hypertrophy associated with radiculopathy. methods: A 56-year-old man with a previous history of S1 root lesion presented with marked calf hypertrophy, muscle pain, cramps, fasciculations, and increased CK level. magnetic resonance imaging and muscle biopsy confirmed true muscle hypertrophy. electromyography (EMG) showed signs of chronic denervation-reinnervation in the right S1 myotome, with greatly increased spontaneous activity (SA) (fasciculations and complex repetitive discharges). Botox(R) was injected in 3 occasions on 4 sites on the right gastrocnemius (20U per site). Symptoms, CK level and SA on EMG (quantified) were evaluated. RESULTS: The patient improved clinically, CK level and SA steadily decreased. CONCLUSIONS: The literature review failed to identify a unique causative factor for muscle hypertrophy related to neurogenic lesions. BTX treatment was effective in our patient with muscle hypertrophy associated with SA. SIGNIFICANCE: We provide further evidence that spontaneous activity secondary to nerve lesion may cause focal muscle hypertrophy. Treatment with BTX should be considered in these conditions.- - - - - - - - - - ranking = 1.8333333333333keywords = hypertrophy (Clic here for more details about this article) |
8/8. Unilateral calf enlargement following S1 radiculopathy.Two cases of unilateral calf enlargement following S1 radiculopathy are reported. "True" muscular hypertrophy could be confirmed by computerized tomography of the muscle. Muscle biopsy disclosed that fiber hypertrophy exceeded grouped fiber atrophy. In one case both fiber types were involved, and in the other mostly type 1 fibers were affected. electromyography revealed dense pseudomyotonic activity and fasciculations. These findings are discussed in view of the current literature.- - - - - - - - - - ranking = 0.33333333333333keywords = hypertrophy (Clic here for more details about this article) |