Pitfalls in the electrodiagnostic studies of sacral plexopathies

Area of Science:

• Neurology
• Neurophysiology

Background:

• Sacral plexopathies (SPs) are complex neurological conditions affecting the sacral plexus.
• Accurate electrodiagnostic (EDX) characterization is crucial for diagnosis and management.

Purpose of the Study:

• To review the electrodiagnostic features and etiologies of sacral plexopathies.
• To discuss the diagnostic challenges associated with identifying SPs.

Main Methods:

• Retrospective review of 171 clinically suspected sacral plexopathy cases.
• Analysis of electrodiagnostic findings including sensory nerve action potentials (SNAPs) and muscle denervation.
• Exclusion criteria included paraspinal denervation.

Main Results:

• Sixty cases were unequivocally localized to the sacral plexus, predominantly cancer-related, followed by traumatic, idiopathic, and iatrogenic causes.
• 111 cases had indeterminate diagnoses.
• Localization was complicated by potential involvement of nerve roots or the sciatic nerve in many cases.

Conclusions:

• Electrodiagnostic findings in sacral plexopathies are often complex and difficult to localize precisely.
• Definitive diagnosis of SPs solely through EDX assessment is frequently not possible.
• Further investigation may be required for definitive diagnosis.