Zutelija Fattorini Matija, Gagro Alenka, Dapic Tomislav, Krakar Goran, Marjanovic Josip
Department of Physical Medicine and Rehabilitation, Children's Hospital Zagreb, Medical School, University of Zagreb, Croatia.
Department of Rheumatology, Children's Hospital Zagreb, Medical School, University of Zagreb, Croatia.
Brain Dev. 2017 Jan;39(1):89-92. doi: 10.1016/j.braindev.2016.07.002. Epub 2016 Jul 21.
Muscular hypertrophy secondary to denervation is very rare, but well-documented phenomena in adults. This is the first report of a child with neurogenic unilateral hypertrophy due to S1 radiculopathy. A 12-year-old girl presented with left calf hypertrophy and negative history of low back pain or trauma. The serum creatinine kinase level and inflammatory markers were normal. Magnetic resonance imaging showed muscle hypertrophy of the left gastrocnemius and revealed a protruded lumbar disc at the L5-S1 level. The protruded disc abuts the S1 root on the left side. Electromyography showed mild left S1 radiculopathy. Passive stretching and work load might clarify the origin of neurogenic hypertrophy but there is still a need for further evidence. Clinical, laboratory, magnetic resonance imaging and electromyography findings showed that S1 radiculopathy could be a cause of unilateral calf swelling in youth even in the absence of a history of back or leg pain.
去神经支配继发的肌肉肥大非常罕见,但在成年人中是有充分文献记载的现象。这是首例因S1神经根病导致神经源性单侧肥大的儿童病例报告。一名12岁女孩出现左小腿肥大,无腰痛或外伤史。血清肌酸激酶水平和炎症标志物正常。磁共振成像显示左侧腓肠肌肌肉肥大,并显示L5-S1水平有腰椎间盘突出。突出的椎间盘压迫左侧S1神经根。肌电图显示轻度左侧S1神经根病。被动拉伸和工作量可能有助于阐明神经源性肥大的起源,但仍需要进一步的证据。临床、实验室、磁共振成像和肌电图检查结果表明,即使没有背部或腿部疼痛史,S1神经根病也可能是青少年单侧小腿肿胀的原因。