Lumbosacral magnetic root stimulation in lumbar plexopathy.

Area of Science:

• Neurology
• Neurosurgery
• Diagnostic Imaging

Background:

• Retroperitoneal hematomas can cause significant neurological deficits.
• Anticoagulation therapy, such as with coumadin, increases the risk of spontaneous hematoma formation.
• Femoral nerve neuropathy can result from compression or infiltration by retroperitoneal masses.

Observation:

• A 76-year-old male presented with weakness in the left femoral nerve distribution.
• The weakness was attributed to a nontraumatic retroperitoneal hematoma.
• The patient was on coumadin anticoagulation, a potential contributing factor.

Findings:

• Standard electrodiagnostic studies like electric root stimulation were relatively contraindicated due to bleeding risk.
• Magnetic lumbosacral root stimulation was employed to assess the nerve damage.
• This technique successfully identified a proximal conduction block, enabling a more comprehensive evaluation of the lumbosacral plexus dysfunction.

Implications:

• Magnetic lumbosacral root stimulation offers a safe and effective alternative for electrodiagnostic assessment in patients with bleeding risks.
• This case highlights the utility of magnetic stimulation in evaluating nerve injuries associated with retroperitoneal hematomas.
• The findings suggest a potential new diagnostic avenue for lumbosacral plexus disorders in specific clinical scenarios.