leuprolide and Muscle-Weakness

We investigated the long-term effects of leuprorelin on leg-muscle strength in spinal and bulbar muscular atrophy (SBMA). We hypothesized that testosterone suppression by leuprorelin would prevent the progression of muscle weakness.. In a prospective, long duration, open trial, 16 SBMA patients underwent medical castration with leuprorelin for 3.5 years. Chlormadinone was coadministered initially to prevent a testosterone surge. The strength of knee extension and flexion were quantitated using a torque machine.. Our hypothesis was rejected. The leg strength measures decreased significantly with the mean reduction of 22.3-27.8%. In a post hoc analysis, the leg strength of 4 patients with higher pretreatment baseline total testosterone levels and short disease duration of 1-6 years were stronger at baseline and decreased by only 12.3-15.7% after treatment.. Leuprorelin was not effective in this small long-term treatment trial in SBMA. The possibility that earlier treatment might be beneficial may deserve further study.

Topics: Adult; Androgen Antagonists; Chlormadinone Acetate; Delayed-Action Preparations; Disease Progression; Humans; Knee; Leuprolide; Longitudinal Studies; Male; Middle Aged; Muscle Strength; Muscle Weakness; Muscular Disorders, Atrophic; Prospective Studies; Treatment Outcome

The aim of this study was to investigate the indications and treatment options in patients with lower-extremity neuropathies and radiculopathies caused by endometriosis.. The authors identified five patients whose symptoms included catamenial pain, weakness, and sensory loss involving the sciatic and femoral nerves and multiple lumbosacral nerve roots. Radiographic studies supported the diagnosis of catamenial neuropathy or radiculopathy, but definitive diagnosis depended on surgical and pathological examination. Treatment of symptoms, including physical therapy and a course of antiinflammatory or analgesic medication, was not helpful. Patients responded favorably to hormonal therapy. Laparoscopy or open exploration for extrapelvic lesions was performed for diagnosis or for treatment when hormone therapy failed. Pain and sensory symptoms responded well to therapy. Weakness improved, but never recovered completely.. Catamenial neuropathy or radiculopathy should be considered when evaluating reproductive-age women with recurring focal neuropathic leg pain, weakness, and sensory loss.

Topics: Adult; Analgesics; Anti-Inflammatory Agents; Antineoplastic Agents, Hormonal; Endometriosis; Female; Femoral Nerve; Humans; Hypesthesia; Laparoscopy; Leuprolide; Low Back Pain; Lumbosacral Plexus; Menstruation; Middle Aged; Muscle Weakness; Muscular Diseases; Neuralgia; Paresthesia; Peripheral Nervous System Diseases; Physical Therapy Modalities; Radiography; Sciatic Nerve; Sciatica; Spinal Nerve Roots; Thigh; Treatment Outcome