[Camptocormia in the elderly patient: myopathy or muscular dystonia?]

Two cases of camptocormia in elderly patients are reported. Both patients presented with an anterior curvature of the trunk which disappeared in the decubitus position. Computed tomography demonstrated hypodensity of the muscles which preceded atrophy. Histological changes were of low specificity and diverse with irregular and a trophic muscle fibers and occasionally endomysial fat or mitochondrial abnormalities. These findings suggest that camptocormia may be the consequence of a disease of spinal muscles. Pathophysiological hypotheses include neurogenic atrophy of spinal muscles, spinal amyotrophy, and delayed primary myopathy. None of these hypotheses was consistent with findings in our two patients. The terms "muscular dystrophy" and "mitochondrial myopathy" occasionally used seem inappropriate in view of the lack of specificity of the lesions. A better term may be "muscular insufficiency", the mechanism of which is still unclear.