Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve

Floyd JR 2nd, John Floyd, John R Floyd, Keeler ER, Elizabeth R. Keeler, Elizabeth D. Euscher, Euscher ED, McCutcheon IE, Ian E. McCutcheon
Journal of neurosurgery. Spine · 2010 · vol. 14(2) , pp. 281–289 · doi:10.3171/2010.10.spine09162 · PMID:21184633 · W1600306235
article OA: closed CC0 ⤵ 34 in-corpus citations
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This case study reports on a woman with catamenial sciatica caused by endometriosis directly affecting the sciatic nerve trunk in her thigh, detailing her diagnosis, surgical intervention, and subsequent improvement.

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Abstract

Sciatic (catamenial) radiculopathy, waxing and waning with the menstrual cycle, is an uncommon condition typically caused by pelvic endometriosis affecting the lumbosacral plexus or proximal sciatic nerve. The authors describe a woman with catamenial sciatica caused by endometriosis affecting the sciatic nerve trunk in the upper thigh. Symptomatic with leg pain for 5 years, this patient developed gluteal atrophy and sensory loss and decreased strength in the L-5 dermatomyotome, a distribution confirmed by electromyography. Magnetic resonance imaging suggested thickening of the sciatic nerve at and distal to the sciatic notch. At operation the nerve showed extrinsic and intrinsic abnormality, proven to be endometriosis. Her symptoms improved, and she began gonadotropin-releasing hormone agonist therapy for further suppression. This very unusual case shows that endometriosis can affect the sciatic nerve over a range of territory inside and outside the pelvis, and that surgery must be appropriately directed to avoid negative exploration. Surgical decompression achieves good relief of symptoms, and medical therapy also allows sustained suppression of this disease.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Menstrual Cycle Sciatica Sciatica Adult Decompression, Surgical Electromyography Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Menstrual Cycle Muscular Atrophy Muscular Atrophy Muscular Atrophy Sciatica Sciatica Sciatic Nerve Sciatic Nerve

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (56)

Cited by (35)

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License: CC0 · commercial use OK