• Thorleif Etgen and Michael Winklmaier.
• Klinik für Neurologie, Klinikum Traunstein.
• Dtsch. Med. Wochenschr. 2022 Apr 1; 147 (10): 613-616.

History And Clinical FindingsA 60-year-old male patient was admitted with a painless reduction in the circumference of the right calf with mild gait disturbance that had been increasing for 6 months. Neurological findings included atrophic monoparesis of the right lower leg with preserved muscle reflexes without sensory disturbances.InvestigationsElectrophysiologically and neuroradiologically, only the right triceps surae muscle showed signs of combined acute and chronic damage and marked atrophy with diffuse muscle oedema. With elevated liver enzymes, previously unknown positive hepatitis C serology and high hepatitis C viral load in serum, even pleocytosis with very low viral load was detectable in the CSF.DiagnosisA diagnosis of hepatitis C-associated mononeuropathy of the right sciatic nerve with focal involvement of the right tibial nerve was made.Therapy And CourseAfter therapy with Sofosbuvir and Velpatasvir, no further progression of the monoparesis occurred during the further course.ConclusionsChronic hepatitis C may be rarely associated with painless progressive monoparesis. With regard to pathogenesis, the significance of CSF requires further studies.Thieme. All rights reserved.

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