Diagnosis and Management of Sciatic Endometriosis at the Greater sciatic Foramen: a Case Report (original) (raw)

Endometriosis of the sciatic nerve

Arquivos de Neuro-Psiquiatria, 2011

Endometriosis is a common disease, which affects 5-10% of women in fertile age 1. It can affect multiple organs, such as ovaries, lungs, colon, nasal mucosa and brain 2. Endometriosis of the sciatic nerve is a rare presentation 3 , manifesting as cyclic sciatica, parestesis and paresis with loss of deep tendon reflex. We cite a case of sciatica endometriosis and make a review of the literature.

Extragenital Endometriosis; A Rare Casue of Sciatica: A Case Report

Türkiye Fiziksel Tip ve Rehabilitasyon Dergisi, 2015

Endometriosis is a common disease characterized by the presence of endometrial tissue outside the uterus, such as over, colon, nasal mucosa. Furthermore, it can affect sciatic nerve as a rare presentation causing cyclic sciatica, chronic pelvic pain, paresis, and paresthesia. Early diagnosis and treatment is very important to minimize the nerve damage caused by endometrial focus on sciatic nerve. Diagnosis of sciatica due to endometriosis can be made by magnetic resonance neurography (MRN), thereby identifying abnormalities of the sciatic nerve in patients with unexplained sciatica. MRN is a sensitive tool for evaluating both the lumbosacral plexus and sciatic nerve. We described a 38-year-old female patient with cyclic sciatica for 4 years. She had an endometrial focus compressing sciatic nerve at left sciatic foramen level that was diagnosed by MRN. In this case report, we aimed to underline the importance of appropriate diagnostic tools in the patients with extraspinal sciatica.

Endometriosis of the sciatic nerve with cyclic sciatica

Acta medica Lituanica, 2014

Endometriosis is an important gynecological disorder which is characterized by proliferation of the functional endometrial tissue outside the uterine cavity, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis invading the sciatic nerve is a rare manifestation of a common disease. The cyclic rhythm of pain, associated with the magnetic resonance imaging (MRI) signal of the lesion should suggest a diagnosis of endometriosis. Early diagnosis and treatment are important to prevent irreversible damage to the sciatic nerve.

Cyclic sciatica caused by infiltrative endometriosis: MRI findings

Skeletal Radiology, 2004

Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1-and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch.

Magnetic resonance neurography for the diagnosis of extrapelvic sciatic endometriosis

Fertility and Sterility, 2010

Objective: To illustrate magnetic resonance neurography findings of severe sciatic injury and muscle denervation related to deep gluteal endometriosis at the sciatic notch. Design: Case report. Setting: Academic teaching hospital. Patient(s): A 39-year-old woman with a 4-year history of sciatica related to the menstrual cycle. Intervention(s): Surgical exploration of the sciatic notch for diagnostic confirmation, external neurolysis of the sciatic nerve, and eventual pharmacologic treatment. Main Outcome Measure(s): Magnetic resonance neurography imaging revealed severe neuropathic injury and muscle denervation related to a deep infiltrative endometriotic focus at the sciatic notch, which was confirmed histologically on surgical exploration. Detailed electrodiagnostic and clinical neurologic examinations at initial presentation and during follow-up were obtained for further assessment of nerve degeneration, muscle denervation, and clinical recovery. Result(s): Initial gynecologic and eventual laparoscopic evaluation on persisting complaints were without pathological findings. When a progressive weakness of the leg was noted, magnetic resonance neurography revealed a severe axonal damage to the sciatic nerve and denervation of distal target muscles related to a diffuse infiltrative lesion at the sciatic notch. On surgical exploration, extragenital endometriosis was confirmed histologically. Considerable improvement in pain and strength occurred after pharmacologic therapy with a GnRH analogue. Conclusion(s): This is the first report to describe imaging findings of magnetic resonance neurography in severe neuropathic injury of the sciatic nerve and subsequent muscle denervation related to a deep infiltrative gluteal endometriotic focus. (Fertil Steril Ò 2010;94:351.e11-e14. Ó2010 by American Society for Reproductive Medicine.

Lumbosacral Plexopathy – an Unusual Presentation of Sciatic Endometriosis

Indian Journal of Case Reports, 2020

Endometriosis is a common gynecologic disorder that presents with chronic pelvic pain or infertility. It is the presence of endometrial tissue outside the uterus. It is typically present in the pelvis, such as on the ovaries and pelvic peritoneum. It may also involve the bowel, ureter or bladder, and the neurovascular bundle in the leg. We, hereby, report that the case of a lady who presented to us with catamenial leg pain on her right side was diagnosed to have lumbosacral plexopathy with underlying etiology as endometriosis on evaluation, an unusual presentation of a disease.

Intrapelvic causes of sciatica: A systematic review

Southern Clinics of Istanbul Eurasia

The sciatic nerve is the nerve of the lower limb. It is derived from spinal nerves, fourth Lumbar (L4) to third Sacral (S3). The sciatic nerve innervates the muscles of the posterior thigh and additionally has sensory functions. Sciatica is the given name to the pain sourced by irritation of the sciatic nerve. Sciatica is most commonly induced by compression of a lower lumbar nerve root (L4, L5, or S1). Various intrapelvic pathologies include gynecological, vascular, traumatic, inflammatory, and tumoral disorders that may cause sciatica. Intrapelvic pathologies that mimic disc herniation are quite always ignored. Surgical approach and a functional exploration by laparoscopy or robotic surgery have significantly increased the intrapelvic pathology's awareness, resulting in sciatica. After a detailed assessment of the patient, which causes intrapelvic pathologies, deciding whether surgical or medical therapy is needed, notable results in sciatic pain remission can be done.