Muscular atrophy and weakness in the lower extremities in Behçet’s disease: A case report and review of literature

BACKGROUND In Behçet’s disease(BD),very few cases of muscular involvement have been reported previously.The natural history and therapeutic protocol for muscular involvement in BD are obscure due to the low incidence of peripheral neuropathy or myopathy in BD.The purpose of our study was to report a rare case of BD with chronic,focal forms of neuromyopathy and review the relevant literature.CASE SUMMARY We herein report the case of a 54-year-old man who presented with progressive muscular atrophy and weakness of both thighs 2 years after the presentation of the cardinal symptoms of BD.The past medical history,electrophysiological study,neurological examination,blood tests,magnetic resonance imaging study,and histological exam were performed for the differential diagnosis.Relevant literature on muscular involvement in BD was reviewed.Neurological examination revealed that muscular involvement was predominantly localized in the proximal parts of the lower extremities.Heterogeneous enhancement of several thigh muscles was observed on magnetic resonance imaging,which corresponded with the clinical manifestations.Histological study of one of the enhanced muscles showed denervation atrophy of the muscle with superimposed myopathic changes,while electrophysiological studies only suggested denervation.CONCLUSION To our knowledge,this is the first case of neurogenic muscular atrophy with a specific set of clinical,radiological,electrophysiological,and histological findings reported in BD.

Iatrogenic giant pseudomeningocele of the cervical spine:A case report

BACKGROUND Only a few cases of giant pseudomeningoceles have been reported in the literature.Herein,we report a giant pseudomeningocele of the cervical spine that was found after cervical laminectomy for an epidural hematoma following epidural blockade.CASE SUMMARY A 47-year-old man presented with recurrent neck pain and posterior neck swelling after spinal surgery.Magnetic resonance imaging of the cervical spine revealed fluid collection(5.6 cm×6.6 cm×11.2 cm)at the C3-6 level;this proved to be a pseudomeningocele.Symptoms related to the pseudomeningocele resolved following dural repair and fat graft transplantation.CONCLUSION Although rare,pseudomeningocele is a possibility in patients with recurrent back pain,radicular pain,or a persistent headache following spinal surgery.Continuous attention should be paid throughout the spinal procedure,whether conservative or non-conservative.

Effect of modified fasting therapy on body weight, fat and muscle mass, and blood chemistry in patients with obesity

OBJECTIVE: The aim of this study was to investigate the effects and safety of modified fasting therapy using fermented medicinal herbs and exercise on body weight, fat and muscle mass, and blood chemistry in obese subjects.METHODS: Twenty-six patients participated in a14-day fast, during which they ingested a supplement made from fermented medicinal herbs and carbohydrates(intake: 400-600 kcal/d). The schedule included 7 prefasting relief days and 14 days of stepwise reintroduction of food. The patients also took part in an exercise program that incorporated Qigong, weight training, and walking exercises. The efficacy of treatments was observed by assessing body fat mass and muscle mass, and alanine aminotransferase(ALT), aspartate aminotransferase(AST),cholesterol, and triglycerides in each study period.Specific symptoms or side effects were reported.RESULTS: Body weight and body fat mass both decreased significantly by(5.16 ± 0.95) and(3.89 ±0.79) kg(both P < 0.05), while muscle mass decreased by an average of(0.26 ± 0.22) kg, without statistical significance. ALT levels were significantly decreased(P < 0.05), while AST levels decreased without statistical significance(P = 0.052). The levels of total cholesterol and triglycerides were also significantly decreased(both P < 0.05). There were few adverse events except for mild dizziness, which did not affect everyday living.CONCLUSION: These results suggest that modified fasting therapy using fermented medicinal herbs and exercise could be effective and safe on obese patients.