Flail leg syndrome misdiagnosed as inflammatory myopathy a case report

Hongda Chen, Ying Chen, Shuda Chen, Chenghui Ye
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Abstract

Objective: To investigate the development and clinical characteristics of flail leg syndrome (FLS) and improve clinicians’ recognition ability of the disease. \quad Method:We reviewed the clinical data, electromyography, cerebrospinal fluid test, and lumbar MRI of a patient diagnosed with flail leg syndrome(FLS) in the seventh Affiliated Hospital of Sun Yat-sen University. \quad Results: Clinical symptoms of the patient limited in both lower limbs, including asymmetric distal muscle weakness and atrophy with conceal onset and slow development. There were also occurrences of increased tendon reflexes and muscle soreness as the disease progressing. Electromyography showed that the amplitude of motor nerve conduction of both lower limbs decreased even disappeared,indicating neurogenic injury.In addition, patient’s blood creatine kinase level was found slightly increased. \quad Conclusion: Flail leg syndrome is a variant type of ALS. It is relatively rare in clinical practice and usually shows slow progress. This case study would be helpful for clinicians to improve the diagnostic ability of FLS.
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连枷腿综合征误诊为炎性肌病1例
目的:探讨连枷腿综合征(FLS)的发生及临床特点,提高临床医生对该病的认识。方法:回顾中山大学第七附属医院诊断为连枷腿综合征(FLS)的患者的临床资料、肌电图、脑脊液检查和腰椎MRI。结果:患者的临床症状局限于双下肢,包括不对称远端肌无力和萎缩,发病隐匿,发展缓慢。随着疾病的进展,还会出现肌腱反射增加和肌肉酸痛。肌电图显示双下肢运动神经传导振幅下降甚至消失,提示神经源性损伤。此外,患者血肌酸激酶水平略有升高。结论:连枷腿综合征是ALS的一种变型。在临床实践中相对罕见,通常表现为缓慢的进展。本病例的研究有助于临床医生提高对FLS的诊断能力。
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