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[Bilateral cyclic sciatica caused by endometriosis. Apropos of a case]
D J Calzada-Sierra1, E Fermín-Hernández, R Vasallo-Prieto
1Centro Internacional de Restauración Neurológica, CIREN, La Habana, Cuba. danny@neuro.sld.cu
Revista De Neurologia
|October 21, 1999
Summary
Cyclical sciatica, a rare condition caused by endometriosis affecting the sciatic nerve, can lead to permanent disability if untreated. Early diagnosis and treatment with depot medroxyprogesterone can effectively manage symptoms.
Area of Science:
- Neurology
- Gynecology
- Pain Management
Background:
- Cyclical sciatica is an uncommon condition where endometriosis implants affect the sciatic nerve.
- It primarily impacts women of childbearing age, presenting as cyclic sciatic nerve pain coinciding with menstruation.
Observation:
- A patient experienced progressive right-sided sciatic pain and motor deficits, including foot drop, correlating with her menstrual cycle.
- Surgical intervention for a misdiagnosed condition worsened her sciatic pain, and contralateral symptoms emerged later.
Findings:
- Clinical, imaging, and electrophysiological data were analyzed, revealing cyclical sciatica due to endometriosis.
- Diagnosis was aided by contrast-enhanced computerized axial tomography of the pelvis.
- The patient showed improvement with depot medroxyprogesterone treatment, leading to complete pain resolution.
Implications:
- Cyclical sciatica from endometriosis is underrecognized and can cause irreversible neurological damage.
- Prompt diagnosis and appropriate treatment, such as hormonal therapy, are crucial for preventing disability.
- This case highlights the importance of considering endometriosis in women with cyclical sciatica.