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Focal myositis of lower extremity responsive to botulinum A toxin.
[focal myositis]
Focal
myositis
is
a
rare
,
mostly
benign
disease
(
pseudotumor
)
of
skeletal
muscle
,
histopathologically
characterized
by
interstitial
myositis
and
tumorous
enlargement
of
a
single
muscle
.
The
etiology
of
focal
myositis
remains
unknown
;
however
,
localized
myopathy
has
been
postulated
to
be
caused
by
denervation
lesions
.
This
case
report
describes
a
patient
that
presented
with
clinical
,
laboratory
,
electromyoneurography
,
and
magnetic
resonance
imaging
features
of
focal
myositis
complicated
with
intervertebral
disk
protrusion
in
the
lumbosacral
spine
affected
with
radicular
distress
.
In
most
cases
,
focal
myositic
lesions
show
spontaneous
regression
,
relapses
are
rare
,
and
long
-term
prognosis
is
good
.
There
is
a
wide
spectrum
of
therapeutic
options
,
from
no
therapy
at
all
through
nonsteroidal
antirheumatics
and
glucocorticoids
to
radiotherapy
,
surgical
excision
,
and
immunosuppressants
.
In
the
patient
presented
,
treatment
with
glucocorticoids
,
methotrexate
,
and
surgical
excision
failed
to
produce
satisfactory
results
.
Clinical
improvement
,
pain
relief
,
and
reduction
in
lower
leg
volume
were
only
achieved
by
local
infiltration
of
botulinum
A
toxin
.
Diseases
Validation
Diseases presenting
"skeletal muscle"
symptom
cadasil
epidermolysis bullosa simplex
esophageal adenocarcinoma
focal myositis
hereditary cerebral hemorrhage with amyloidosis
inclusion body myositis
lamellar ichthyosis
neuralgic amyotrophy
pleomorphic liposarcoma
pyomyositis
pyruvate dehydrogenase deficiency
systemic capillary leak syndrome
well-differentiated liposarcoma
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