Polymyositis presenting with chronic progressive distal muscular weakness.

A 55-year-old woman with a 6-year history of progressive asymmetrical distal muscular weakness of the upper and lower limbs is described. A diagnosis of polymyositis was confirmed by two muscle biopsies. Prednisone therapy resulted in marked clinical improvement.     

Hereditary distal myopathy with onset in early infancy: Observation of a family

The study of a family affected with hereditary distal myopathy with onset in early infancy is presented. Complete neurological examination was necessary in several members of the two last generations to discover the existence of the abnormalities of which they were unaware.The propositus was the most affected member of the family with distal paresis of the upper and lower extremities and selective paresis of the deltoid muscles. In addition he had kyphoscoliosis, talipes valgus and limitation of mobility of several joints. The onset of the disease was estimated as before the age of 2 when the child started walking. There was no progression of the disease. Clinical examination suggested a myopathic origin of the condition. A sural nerve biopsy was normal. Light-microscopy histochemical studies disclosed a predominance of type I fibres which were at the same time hypotrophic. Subsarcolemmal deposits of mitochondria were present although they were scanty and of normal ultrastructural appearance. In view of the morphological presentation it is postulated that this disease should be classified within the group of myopathies accompanied by disproportion of fibres and selective atrophy of type I fibres.     

Predictability of the result of surgical intervention in patients with low back pain

Patients who were to undergo surgical intervention for low back pain were investigated preoperatively. The effect of surgical intervention was determined after 6 months. The judgement of the neurosurgeon and of the patients themselves were used to assign patients to three outcome categories: satisfactory, moderate and unsatisfactory. Differences in several psychological and biological factors were found between the three categories. On the basis of preoperatively assembled data on psychological and other variables it is possible to predict the outcome of surgical intervention in 80% of the patients.