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Crural amyotrophy associated with a parietal lesion: a case report
G Pozzessere1, E Valle, M Tomaselli
1Mediterranean Institute of Neuroscience, Pozzilli (Isernia), Italy.
Acta Neurologica Belgica
|January 1, 1995
Summary
A rare case of leg muscle atrophy linked to a brain tumor was studied. This "parietal" or "central" origin of muscle wasting offers new insights into neurological conditions.
Area of Science:
- Neurology
- Neuro-oncology
- Clinical Neuroscience
Background:
- Muscle atrophy and motor dysfunction are typically associated with peripheral nerve or spinal cord issues.
- Cortical lesions are less commonly linked to distal limb amyotrophy, particularly in the leg.
Observation:
- A 33-year-old woman presented with a 3-year history of left leg and foot muscle atrophy and impaired motor function.
- The patient had a right parietal oligodendroglioma, identified via Magnetic Resonance Imaging (MRI).
- Clinical, electrophysiological (electromyography, motor evoked potentials, somatosensory evoked potentials), and neuropsychological assessments were conducted annually.
Findings:
- Neurological examination revealed abnormal gait, foot drop, pes cavus, and pyramidal signs.
- Electrophysiological studies showed abnormal motor evoked potentials (MEP) and tibial somatosensory evoked potentials (t-SEP) on the affected left side.
- Electromyography (EMG) and neuropsychological tests remained normal throughout the three-year observation period.
Implications:
- The findings suggest a potential 'parietal' or 'central' origin for the observed crural amyotrophy, challenging traditional understandings of muscle wasting.
- This case highlights the possibility of distal limb muscle atrophy resulting from a contralateral cortical lesion, a phenomenon more frequently observed in the hand.
- The study contributes to the understanding of the complex relationship between central nervous system lesions and peripheral muscle function.