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At least 19 recordsLinked to original sources
PubMed2002

Intraoperative positioning during cesarean as a cause of sciatic neuropathy.

BACKGROUND: Sciatic nerve compression has been well documented as a cause of perioperative sciatic neuropathy but rarely during cesarean. CASE: A parturient complained of left foot drop after cesarean delivery for twins performed under spinal anesthesia. Intraoperatively, her right hip was raised with padding under the right buttock to tilt the pelvis approximately 30 degrees to the left. Postoperatively, the patient had weakness, sensory changes, and diminished reflexes in the left lower extremity. Electrodiagnostic studies supported a diagnosis of neurapraxia and partial denervation in the distribution of the sciatic nerve. By postpartum week 6, she had full recovery. CONCLUSION: Elevating the right buttock during cesarean can cause compression of the underlying structures of the left buttock and result in sciatic neuropathy. Decreasing the duration of time the patient is in the left lateral position may reduce the risk of this uncommon but debilitating complication.

Adult↗
PubMed1992

Sciatic neuropathy associated with persistent sciatic artery.

Persistent sciatic artery is a congenital vascular anomaly of the arterial supply to the lower extremity. Thrombosis, distal embolization, aneurysmal dilatation, and rupture of this vessel with compression of the sciatic nerve have been recorded. Although rare in occurrence, complications of persistent sciatic artery should be included in the differential diagnosis of sciatic neuropathy. We present a case of an acute sciatic neuropathy secondary to pseudoaneurysm formation of a persistent sciatic artery. We demonstrate the diagnostic usefulness of magnetic resonance imaging.

Adult↗
PubMed2003

Use of an ankle-foot orthosis in a dog with traumatic sciatic neuropathy.

Traumatic unilateral sciatic neuropathy secondary to a gunshot wound was diagnosed in a seven-month-old, intact male golden retriever. Findings on neurological assessment, performed after cardiovascular stabilisation, were incompatible with a return to normal limb function. An ankle-foot orthosis was used to correct excessive flexion of the digits and tarsus. This device greatly improved the dog's willingness to ambulate and could serve as an alternative to amputation in companion animals with severe sciatic axonotmesis or neurotmesis. Complications associated with chronic tibiotarsal hyperflexion necessitated a pantarsal arthrodesis one year after initial presentation; the dog also developed cranial cruciate disease in the affected limb three years after the gunshot injury.

Animals↗
PubMed1999

Sciatic neuropathy.

Injuries to the sciatic nerve cause neurologic deficits in the peroneal and tibial nerve distributions. Interestingly, most injuries result in more severe deficits to the peroneal division compared to the tibial division. Thus, it can sometimes be difficult to distinguish sciatic neuropathy from peroneal neuropathy. The long course of the sciatic nerve leaves it vulnerable to nerve injury from a variety of causes. Most sciatic neuropathies are acute in onset, such as from hip arthroplasty and hip fracture or dislocation, but some occur from prolonged compression, such as during coma. Entrapment of the sciatic nerve by mass lesions or by the piriformis muscle is relatively rare.

Decompression, Surgical↗
PubMed1989

Intraoperative cortical somatosensory evoked potentials for detection of sciatic neuropathy during total hip arthroplasty.

Approximately 3% of patients undergoing hip arthroplasty develop postoperative sciatic neuropathy. The factors associated with changes in somatosensory evoked potentials (SSEP) and sciatic neuropathy were examined in patients undergoing hip arthroplasty, to evaluate whether the use of intraoperative SSEP could help reduce the incidence of postoperative sciatic neuropathy. Eighty-eight patients were assigned to either monitored or unmonitored groups. SSEP were recorded following peroneal nerve stimulation, using contralateral stimulation to detect systemic influences on SSEP. Amplitude reduction of less than 50% of control and/or latency increase of greater than 10% of control was considered significant, and surgical intervention was attempted to restore SSEP. Previous surgery and a lateral incision approach tended to be associated with sciatic neuropathy (p less than 0.053). The incidence of sciatic neuropathy in the monitored group (4.3%) was not different from the unmonitored group (2.4%). Isolated reduction in amplitude or prolongation in latency of the SSEP was not predictive of postoperative neurologic function of the sciatic nerve. Six patients, two of whom developed sciatic neuropathy, demonstrated complete flattening of the SSEP. Both of these patients had flattened SSEP for two or more surgical events (p less than 0.01) and flattened SSEP were present at the end of the surgical procedure. There were no false-negative SSEP changes. Simultaneous amplitude and latency changes appear to be predictive of sciatic nerve function following hip arthroplasty.

Evoked Potentials, Somatosensory↗
PubMed2004

Traumatic venous varix causing sciatic neuropathy: case report.

OBJECTIVE AND IMPORTANCE: Sciatic neuropathy rarely presents in nonpenetrating trauma because of protection of the nerve by the pelvis, the gluteal muscles, and the tissues in the posterior thigh. We present the case of a patient who fell and subsequently developed a traumatic venous varix of the inferior gluteal vein that caused compression sciatic neuropathy. CLINICAL PRESENTATION: Seven days after a fall onto her right buttock, the patient developed a painful burning paresthesia in her leg and numbness on the dorsum of her foot. Numerous studies ruled out lumbar spine pathological abnormalities as the cause of the pain. Conventional magnetic resonance imaging revealed a lesion adjacent to the sciatic nerve. Gradient echo and two-dimensional time-of-flight magnetic resonance imaging sequences confirmed this to be a vascular lesion originating from the inferior gluteal vein and compressing the sciatic nerve. INTERVENTION: Operative resection obliterated the venous varix, thereby relieving the patient's pain and neurological deficit. CONCLUSION: No case of a traumatic venous varix of the inferior gluteal vein compressing the sciatic nerve has been reported to date. Surgical resection was successful in obliterating the lesion and relieving the symptoms.

Accidental Falls↗
PubMed1994

Sciatic neuropathy: clinical and prognostic features in 73 patients.

We examined the clinical features of patients with sciatic neuropathy and the factors that influence prognosis. Of 92 consecutive patients referred for EMG evaluation of sciatic neuropathy, 73 fulfilled strict inclusion and exclusion criteria and had adequate clinical and electrophysiologic information. The etiologies included hip arthroplasty (21.9%), acute external compression (13.7%), infarction (9.6%), gunshot wound (9.6%), hip fracture/dislocation (9.6%), femur fracture (4.1%), contusion (4.1%), and uncertain (16.4%). We used life table analysis to determine outcome and to identify prognostic factors in patients with acute or subacute onset. Moderate or better recovery (improvement to grade 2 or by two of six clinical grades) occurred in most patients (30% by 1 year, 50% by 2 years, 75% by 3 years). A subgroup experienced excellent improvement (by three of six grades, or to grade 2) less frequently (33% by 2 and 3 years). Of the nine factors tested, two predicted an earlier or better recovery: a recordable compound muscle action potential of the extensor digitorum brevis (p < 0.025), and an initial absence of paralysis of muscles controlling ankle plantar flexion and dorsiflexion (p < 0.05). Thus, good but incomplete recovery occurs over 2 to 3 years in most patients with sciatic neuropathy, particularly in those without severe motor axonal loss.

Action Potentials↗
PubMed1996

Sciatic neuropathies--a retrospective review of electrodiagnostic features in 29 patients.

Sciatic neuropathy is an uncommonly diagnosed focal mononeuropathy. We reviewed the aetiology and electrodiagnostic features of 29 patients studied at the Neurodiagnostic Laboratory, Tan Tock Seng Hospital from January 1989 to April 1995. External nerve compression was the most common cause (38%) followed by trauma (21%). Other rare causes in this series included intragluteal injections, hip surgery and diabetic mononeuropathy while 24% had uncertain aetiology. Electrodiagnostic studies showed preferential involvement of the peroneal division in 51%. Axonal loss was found in 97%. We conclude that sciatic neuropathy often mimics distal peroneal nerve dysfunction and neurophysiological studies are essential for diagnosis. Furthermore, these studies are necessary for assessing prognosis in relation to axonal loss.

Adolescent↗
PubMedDate not supplied

Sciatic neuropathy secondary to a uterine fibroid: a case report.

Lesions of the sciatic nerve outside the pelvis have been well described. Lesions within the pelvis, however, are far less common. We report the case of a 55-yr-old woman with a history of chronic low back pain who presented with progressive right buttock and posterolateral right lower limb pain associated with right foot numbness and tingling. She denied any associated low back or left lower limb pain. The patient was initially treated for a probable right lumbosacral radiculopathy, without improvement. A subsequent magnetic resonance image of the lumbosacral spine revealed multilevel disc degeneration at L3-4 through L5-S1, without disc herniation or canal stenosis. A magnetic resonance image of the pelvis revealed a markedly enlarged uterus, with a large pedunculated myoma impinging on the right sciatic foramen. The patient underwent a subtotal abdominal hysterectomy, with resolution of her right lower limb pain. This case illustrates the importance of considering intrapelvic causes of sciatic neuropathy. To our knowledge, this is the first reported case of sciatic neuropathy secondary to a uterine fibroid.

Chronic Disease↗
PubMed1980

Femoral and sciatic neuropathies after total hip arthroplasty.

Six patients with peripheral nerve lesions after total hip replacements were reviewed. The incidence of peripheral nerve lesions was six out of 825, i.e. 0.7 per cent. The neuropathies, four sciatic, one femoral and one combined femoral and sciatic, were due to damage by the reamer in one case, haemorrhage in two, whereas the cause was unknown in three patients. After conservative treatment and 1-5 years follow-up the recovery was classified as good in three, fair in one and poor in two patients.

Aged↗
PubMed1999

Sciatic neuropathy secondary to total hip arthroplasty wear debris.

Sciatic neuropathy after total hip arthroplasty can result from several causes. We present a case in which a large cystic mass developed around a failed total hip arthroplasty. The lesion extended through the greater sciatic notch and into the pelvis producing sciatic nerve compression. The diagnosis was delayed, and the patient underwent a laminectomy without relief of symptoms before an abdominopelvic computed tomography (CT) scan revealed the mass. After revision of the components and excision of the accessible portion of the lesion, the symptoms improved. Resolution of the intrapelvic portion of the mass was demonstrated on follow-up CT scan, suggesting that retroperitoneal resection of this type of lesion may not be required at the time of revision of the components.

Aged↗
PubMed2001

Sciatic neuropathy secondary to infiltrating intermuscular lipoma of the thigh.

Sciatic neuropathy is a rare mononeuropathy of the lower limbs that is commonly misdiagnosed as spinal stenosis or herniated nucleus pulposus. We describe an unusual case in which a patient underwent surgical excision of a large soft-tissue mass on his right side that involved the posterior and medial compartment of the thigh with displacement of the sciatic nerve posteriorly. The patient had full resolution of his pain and restoration of his neurologic function.

Electromyography↗
PubMed1995

The electrophysiologic features of sciatic neuropathy in 100 patients.

We reviewed the electrophysiologic data of 100 consecutive patients with sciatic neuropathy in order to better understand this disorder. Most patients (93%) had electrodiagnostic signs of significant axonal loss. Seven patients had predominantly signs of demyelination; 6 were due to compression and 1 was idiopathic. The peroneal division was more severely affected than the tibial division in 64% of patients. Tibialis anterior EMGs were abnormal in 92%, and the EDB CMAP was low in amplitude or absent in 80%. CMAP and SNAP amplitudes and EMGs were all normal in the tibial division in 12%. In contrast, the tibial division was more severely affected in only 8 patients. Of those, 5 were due to thigh trauma (gunshot wounds or femur fracture), 2 from gunshot wounds to the hip, and the other was chronic and idiopathic. Sciatic neuropathies are commonly, but not always, axonal loss lesions that affect the peroneal greater than tibial division.

Action Potentials↗
PubMed1989

Trochanteric sciatic neuropathy.

A patient with severe weakness, atrophy, and sensory loss of the right leg had a focal right sciatic neuropathy. The sciatic nerve was enlarged at the level of the lesser trochanter, excessively firm, and multistranded; its stimulation threshold was focally increased. Biopsied fascicles had reduplicated perineurial leaflets, many Renaut bodies, and an abnormal unimodal spectrum of small-diameter fibers. We postulate that the lesion was induced by the combination of an underlying prominent lesser trochanter and sitting on hard benches.

Atrophy↗
PubMed2001

Sciatic neuropathy caused by disorder of a nutrient artery: a case report of thromboembolism secondary to profunda femoral artery aneurysm.

This report describes a case of sciatic neuropathy caused by an obstruction of the nutrient artery of the nerve. The patient was a 76-year-old man who had an aneurysm in his right thigh and suddenly complained of pain and weakness in his right leg. Computed tomography scan and ultrasonography of the right thigh showed an aneurysm with a thrombus in the lumen of the profunda femoral artery. His symptoms did not immediately improve after the aneurysm had been resected, and were consistent with right sciatic neuropathy. Recovery of strength of the right tibialis anterior muscle from 0/5 to 3/5 required 12 months. In this case, thromboemboli from the aneurysm were thought to have obstructed the profunda femoral artery, which supplied the sciatic nerve via perforating arteries.

Aged↗
PubMedDate not supplied

Sacral plexopathy and sciatic neuropathy after total knee arthroplasty.

While peroneal and tibial neuropathies have been described as a complication of total knee arthroplasty (TKA), a computerized literature search failed to reveal any previously reported cases of associated sacral plexopathy or sciatic neuropathy. This case report describes the diagnosis and management of a patient found to have evidence of a right sacral plexopathy and a left sciatic neuropathy, following bilateral TKA. This case suggests that these may be rare complications of TKA.

Arthroplasty, Replacement, Knee↗
PubMed1985

Sciatic neuropathy secondary to migration of trochanteric wire following total hip arthroplasty.

Delayed sciatic neuropathy secondary to migration of a free segment of trochanteric wire in an otherwise successful total hip arthroplasty seems not to have been reported previously. A 60-year-old woman with a total hip arthroplasty with a lateral transtrochanteric approach had the trochanter reattached with two 18-gauge Vitallium wires. The osteotomy healed uneventfully despite a break in the vertical wire ten days after surgery. Five years and ten months later, the patient began to have severe sciatic pain. Roentgenograms showed a free fragment of trochanteric wire posterior to the hip joint. On exploration, the 2-cm wire fragment was found to lie entirely within the epineurium of the sciatic nerve.

Female↗
PubMed1988

Sciatic neuropathies in childhood: a report of ten cases and review of the literature.

Primary lesions affecting the sciatic nerve are uncommon, especially in children. Isolated sciatic nerve involvement was found in ten patients during an 8 1/2-year period at a metropolitan children's hospital. Etiologic mechanisms included three with compression and one each with stretch injury after operation using the lithotomy position, stretch injury after closed reduction of hip dislocation, puncture wound, lymphoma, hypersensitivity vasculitis associated with hypereosinophilia, indeterminate lesion associated with transverse myelitis, and idiopathic progressive lesion with negative findings on exploration. Neonatal injuries associated with breech delivery or intragluteal injections were not causative factors in this series. Children with sciatic neuropathies have a variable prognosis depending on the etiology. Compression was the only potentially preventable pathophysiologic mechanism.

Adolescent↗