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[A swollen, painless calf caused by neurogenic muscle (pseudo)-hypertrophy]
B P van de Warrenburg1, M J Zwarts, B G van Engelen
1Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen, Afd. Neurologie. b.vandewarrenburg@neuro.umcn.nl
Abstract:
Neurogenic muscle (pseudo) hypertrophy of the calf was diagnosed in a 60-year-old man, who presented with chronic, painless and unilateral calf enlargement caused by a chronic S1 radiculopathy due to a lumbar disc hernia in the L5-S1 interspace. The differential diagnosis of a swelling of the calf is extensive. Unilateral painless calf enlargement caused by peripheral nerve disorders is rare and relatively unknown. Neurogenic hypertrophy or pseudohypertrophy of the calf muscles in the context of a chronic S1 radiculopathy has to be included in the differential diagnosis of an unexplained calf enlargement. The underlying pathophysiological mechanism is unclear, but probably includes compensatory hypertrophy, abnormal stretching, and spontaneous electrical activity of denervated muscle fibres.
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