Two Cases of Benign Monomelic Amyotrophy of the Lower Extremities
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1 Journal of the K. S. C. N. Vol. 2, No. 2 Two Cases of Benign Monomelic Amyotrophy of the Lower Extremities Dong Kuck Lee, M.D. Department of Neurology, School of Medicine, Catholic University of Daegu - Abstract - Benign monomelic amyotrophy(bma) is an uncommon cause of progressive mildly disabling atrophy and weakness of a limb. It predominantly affects the distal upper limb of young men. I present two men with BMA of the lower extremities. Although the disorder seemed clinically confined to a arm or leg, I confirmed by electromyography evidence of denervation in the other extremities. I reviewed the literatures and discuss the differential diagnosis. BMA is a diagnosis of exclusion that requires consideration in men with unilateral arm or leg atrophy and weakness. Key Words : Benign monomelic amytrophy CASE REPORTS Case No
2 Case No. 2 D I S C U S S I O N 126 Journal of the K. S. C. N. 2000
3 Table 1. Monomelic amyotrophy synonyms 5 Monomelic atrophy Benign focal atrophy Benign focal amyotrophy Benign monomelic amyotrophy Distal amyotrophy of predominantly the upper limbs Juvenile segmental muscular atrophy Juvenile type of distal and segmental atrophy of upper extremities Juvenile muscular atrophy of the upper extremity Juvenile nonprogressive muscular atrophy localized in hand and forearm Juvenile distal spinal muscular atrophy of upper extremities Juvenile amyotrophy of distal upper extremity Non-familial spinal segmental muscular atrophy in juvenile and young subjects Non-familial juvenile distal spinal muscular atrophy of upper extremity Non-familial juvenile central neurogenic muscular atrophy Focal cervical poliopathy causing juvenile muscular atrophy of distal upper extremity Monomelic spinal muscular atrophy Benign juvenile focal muscular atrophy of upper extremities Spinal monomelic amyotrophy Unilateral juvenile muscular atrophy of upper limbs 127
4 128 Journal of the K. S. C. N. 2000
5 syndrome: a clinical, electrophysiological and histopathological study. Clin Neurol Neurosurg 1981;83-1: Riggs JE, Schochet SS, Jr, Gutmann L. Benign focal amyotrophy. Arch Neurol 1984;41: Di Muzio A, Delli Pizzi C, Lugaresi A, Ragno M, Uncini M. Benign monomelic amyotrophy of lower limb: a rare entity with a characteristic muscular CT. J Neurol Sci 1994;126: Hamano T, Mutoh T, Hirayama M, Ito K, Kimura M, Aita T, et al. MRI findings of benign monomelic amyotrophy of lower limb. J Neurol Sci 1999;165: Mimachkie MM, Justiz W, Vriesendorp FJ. Benign monomelic amyotrophy of the lower extremity: report of two cases and literature review. J Clinical Neuromuscular Disease 2000 ; 1 : Mitsumoto H, Cwik VA, Neville HE, Pestronk A, Shields R. Benign focal amyotrophy. Continuum 1997;3: Di Guglielmo G, Brashe C, Di Muzio A, Uncini A. Benign monomelic amyotrophies of upper and lower limb are not associated to deletions of survival motor neurons gene. J Neurol Sci 1996 ; 141 : Serratrice G. Spinal monomelic amyotrophy. In: Rowland LP. Advances in neurology. Vol.56. New York:Raven Press. 1991; Uncini A, Servidei S, Delli Pizzi C, Cutarella R, Di Muzio A, Gambi D, et al. Benign monomelic amyotrophy of lower limb: report of three cases. Acta Neurol Scand 1992;85: Donofrio PD. Monomelic amyotrophy. Muscle Nerve 1994 ; 17: Hirayama K, Toyokura Y, Tsubaki T. Juvenile muscular atrophy of unilateral upper extremity: a new clinical entity. P s y c h i a t r i c Neurol JPN 1959 ; 61 : Prabhakar S, Chopra JS, Banerjee AK, Rana PVS. Wasted leg Gourie-Devi M, Suresh TG, Shankar SK. Monomelic amyotrophy. Arch Neurol 1984;41: Hirayama K, Tomonaga M, Kitano K, Yamada T, Kojima S, Arai K. Focal cervical poliopathy causing juvenile muscular atrophy of distal upper extremity: a pathological study. J Neurol Neurosurg Psy1 987 ; 50 : Brahe C, Servidei S, Zappata S, Ricci E, Tonali P, Neri G. Genetic homogeneity between childhood-onset and adult-onset autosomal recessive spinal muscular atrophy. L a n c e t 1995 ; 346 : Lefebvre S, Burglen L, Reboullet S, Clermont O, Burlet P, Cruaud C, et al. Identification and characterization of a spinal muscular atrophy-determining gene. Cell 1995;80: Baruah JK, Baruah GR. Monomelic leg atrophy: spinal stenosis or a focal myopathy? Muscle Nerve 2000;23: de Visser M, Ongerboer BW, Verbeeten B, Jr. Electromyographic and computed tomographic findings in five patients with monomelic spinal muscular atrophy. Eur Neurol 1988 ; 28:
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