LETTERS to the EDITOR Calf Muscle Hypertrophy
Clinical Neuropathology, Vol. 37 – No. 3/2018 – Letters to the editor 146 LETTERS TO THE EDITOR sias in the right foot and continuous calf pain. Routine blood tests, including sedimentation rate, C-reactive protein, eosinophil count, Calf muscle hypertrophy thyroid hormones, liver enzymes, and cry- following S1 radiculopathy: ocrit were within normal ranges. ANA-ENA screening and search for neurotrophic vi- Letter A stress disorder caused by ruses were negative. Serum creatine kinase ©2018 Dustri-Verlag Dr. K. Feistle hyperactivity with variable (CK) was increased (520 UI/L). ISSN 0722-5091 response to treatment Needle electromyography (EMG) showed DOI 10.5414/NP301093 e-pub: February 16, 2018 marked abnormalities consisting of continu- Nila Volpi1,2, Federica Ginanneschi1,2, ous complex repetitive discharges (CRDs), Alfonso Cerase1,3, Salvatore Francesco polyphasic motor unit potentials with reduced Carbone4, Margherita Aglianò1, voluntary recruitment in the right gastroc- Paola Lorenzoni1, Matteo Bellini3, nemius muscle. EMG recordings of right Sabina Bartalini2, Giovanni Di Pietro5, tibialis anterior, quadriceps femoris, gluteus and Alessandro Rossi1,2 maximum, and adductor magnus muscles were unremarkable. 1Department of Medical, Surgical, and Magnetic resonance imaging (MRI) (Fig- Neurological Sciences, University of ure 1) showed a volume increase of right leg Siena, 2Unit of Neurology and Clinical posterior muscles, more evident on soleus Neurophysiology, 3Unit of Neuroradiology, and medial gastrocnemius, with intrafascial 4Unit of Diagnostic Imaging, and edema and mild hypervascularization of hy- 5Unit of Neurosurgery, University pertrophic muscles. Hospital Santa Maria alle Scotte, Lumbosacral spinal MRI and computed Siena, Italy tomography (Figure 1) evidenced diffuse de- generative disease of the lumbar spine and a L5-S1 right paramedian posterior disc herni- Sir, – Neurogenic focal muscle hyper- ation compressing the ipsilateral S1 radicular trophy (NMH) is a rare event in different sheath and S1 nerve root.
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