Myokymia, muscle hypertrophy and percussion "myotonia" in chronic recurrent polyneuropathy.
ABSTRACT Three unusual features were observed in a patient with chronic relapsing polyneuropathy: myokymia, muscle hypertrophy, and prolonged contraction in response to muscle percussion. Low nerve conduction velocity and conduction block were demonstrated in all motor nerves tested, indicating a demyelinating peripheral neuropathy. Myokymia was caused by spontaneous motor unit activity which was shown to originate in peripheral nerves, since it persisted after nerve block and was abolished by regional curarization. Muscle hypertrophy was attributed to increased peripheral nerve activity, and the prolonged contraction of muscle in response to direct percussion was attributed to irritability of intramuscular nerve terminals.
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ABSTRACT: To determine the clinical, pathological, and magnetic resonance imaging (MRI) characteristics and outcome of focal myositis of the calf associated with S1 radiculopathy. Case report and systematic review of literature using a literature review based on a Medline search from 1950 to 2006. Only cases with myositis documented on muscle biopsy examination were included. Six patients, including ours, with focal myositis of the calf associated with chronic S1 radiculopathy have been reported. Creatine phosphokinase levels were high in 5 cases. MRI provided evidence of global hypertrophy and inflammatory signals affecting the whole of 1 or several muscle heads of the triceps. Electromyography confirmed the existence of neurogenic abnormalities with nearly constant spontaneous activity. Histological analysis of muscle tissue showed an inflammatory infiltrate and denervation lesions. Progression was slow and corticosteroid treatment had little effect. There was no extension toward a diffuse form. Hypertrophy in a denervated muscle should lead the physician to consider a diagnosis of localized secondary myositis. On the other hand, localized hypertrophic myositis is suggestive of previous radicular distress in the territory concerned. The identification of this condition in focal myositis makes it possible to avoid unnecessary additional investigations and escalation of treatment.Seminars in Arthritis and Rheumatism 09/2008; 38(1):20-7. · 3.81 Impact Factor
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ABSTRACT: A 47-year-old male presented with painful swelling of the right calf. His medical history was negative, except for a herniation of disc LIV-V 5 years before. Physical examination revealed unilateral calf hypertrophy with moderate weakness of plantarflexion, mild paresis of dorsiflexion. Electromyography showed a peripheral neurogenic lesion in the right anterior tibial muscle, but normal findings were obtained from the unaffected quadriceps muscle. Histological examination of the right gastrocnemic muscle showed neurogenic changes with typical targetoid fibers, but no pathological changes were present in the quadriceps muscle. Chronic asymmetric spinal muscular atrophy is an infrequent neuromuscular disease and because of asymmetric appearance, it might be difficult to distinguish from other, acquired neurogenic muscle diseases such as radiculopathy caused by intervertebral disc herniation. Our case confirms that muscular hypertrophy can follow partial denervation in humans.Pathology & Oncology Research 02/2006; 12(4):254-6. · 1.56 Impact Factor
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ABSTRACT: Objective To review the literature on well-documented cases of neurogenic muscle hypertrophy in order to define significant features of this disease.Journal De Radiologie - J RADIOL. 01/2005; 86(2):133-141.