Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Sporadic case of non-progressive neurogenic muscular atrophy localized in both calf muscles

Kenju Hara, M.D.1), Maki Tateyama, M.D.2), Naoki Suzuki, M.D.2), Ken Shibano, M.D.1), Keiko Tanaka, M.D.3) and Hideaki Ishiguro, M.D.1)

1)Department of Neurology, Akita Red Cross Hospital
2)Department of Neurology, Tohoku University
3)Department of Neurology, Kanazawa Medical University

A 60-year-old woman was admitted to our hospital because of difficulty in standing on her toes. Neurological examination showed muscle weakness in both calf muscles. Her serum creatine kinase (CK) level was slightly elevated. MRI revealed hyper-intense signals localized in both the gastrocnemius and soleus muscles. Histological examinations of biopsied muscle specimens showed a marked variation in fiber size, small angular fibers, and hypertrophic and splitting fibers, but no muscle fiber necrosis or regeneration or inflammatory cell infiltration. ATPase stained sections showed small grouped atrophy of type 1 fibers. NADH-TR stained sections showed target/targetoid fibers predominantly in type 1 fibers. Dysferlin immunoreactivity was normal. Follow-up clinical evaluation for one year showed no progression. This patient was diagnosed as having an unknown type of spinal muscular atrophy or benign calf amyotrophy. Sporadic cases characterized by elderly-onset, neurogenic muscular atrophy localized in both calf muscles, and non-progressive course are extremely rare in Japan.
Full Text of this Article in Japanese PDF (7404K)

(CLINICA NEUROL, 53: 551|554, 2013)
key words: sporadic, calf muscle, non-progressive, benign calf amyotrophy, spinal muscular atrophy

(Received: 6-Dec-12)