Sciatic neuropathy developed after injection during curettage

Altıntaş A, Ayşe ALTINTAŞ, Ayşe Altıntaş, Ayşegül Gündüz, Gündüz A, Fatih Kantarcı, Kantarcı F, Gözübatık Çelik G, Gökçen Gözübatık Çelik, Koçer N, Naci Koçer, Kızıltan ME, Meral E Kızıltan
Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology · 2016 · doi:10.5505/agri.2014.30974 · PMID:27225613
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This case report describes sciatic neuropathy developing after intramuscular injection during curettage, highlighting endometriosis as a less common cause of sciatic nerve injury.

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This case report describes a patient who developed sciatic neuropathy following an intramuscular injection administered during curettage while in a prolonged lithotomy position under sedation. The authors highlight that while intramuscular injections are the most common cause of such injuries in developing countries, other etiologies like endometriosis or vascular malformations are rarer causes that require careful differential diagnosis using electrophysiology and magnetic resonance imaging. The paper emphasizes the importance of recognizing iatrogenic nerve damage as a potential complication of gynecological procedures involving specific positioning and sedation. Relevance to endometriosis: listed as one of the rarer causes of sciatic neuropathy in the introduction, though the paper's main focus is on iatrogenic injury from injection during curettage.

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Abstract

Intramuscular injections are likely the most common cause of sciatic nerve injury in developing countries. Less common causes include piriformis syndrome, primary tumors of the sciatic nerve, metastatic tumors invading or compressing the nerve, endometriosis, vascular malformations, and prolonged immobilization or positioning. While the most reliable diagnostic and prognostic methods include nerve conduction studies and electromyography, magnetic resonance imaging has been suggested as an alternative method of determining type of lesion, establishing location, and investigating level of nerve involvement. A case of sciatic neuropathy that developed after intramuscular injection, with patient in prolonged lithotomy position and under sedation, is described.
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Keywords

Sciatic neuropathy, Magnetic resonance imaging, Electrophysiology

Abstract

Intramuscular injections are probably the most common causes of sciatic nerve injury in developing countries. Piriformis syndrome, primary tumors of sciatic nerve, metastatic tumors invading or compressing the nerve, endometriosis, vascular malformations, prolonged immobilization or specific positions are rarer causes of sciatic neuropathy. Although the most reliable methods are nerve conduction studies and electromyography for diagnosis, and prognosis, magnetic resonance imaging is also suggested to be an alternative investigation method to determine the type of lesion, to establish its site and the level of nerve involvement. Here, we present a case with sciatic neuropathy which developed after intramuscular injection during a prolonged lithotomy position under sedation.

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Condition tags

endometriosis

MeSH descriptors

Anti-Inflammatory Agents, Non-Steroidal Diclofenac Postoperative Complications Sciatic Nerve Sciatic Neuropathy Adult Anti-Inflammatory Agents, Non-Steroidal Anti-Inflammatory Agents, Non-Steroidal Diagnosis, Differential Diclofenac Diclofenac Dilatation and Curettage Female Humans Hydatidiform Mole Hydatidiform Mole Injections, Intramuscular Injections, Intramuscular Postoperative Complications Pregnancy

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