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[Atypical sciatica].

P Christen1, N Goebel, M Pfab

  • 1Klinik für Rheumatologie und Rehabilitation, Stadtspital Triemli, Zürich.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|January 16, 1990
PubMed
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A presacral mass was identified as a neurinoma causing sciatica and leg weakness in a patient. Surgical removal is recommended, though the patient opted for observation due to mild symptoms.

Area of Science:

  • Neurology
  • Oncology
  • Radiology

Background:

  • Sciatica and progressive motor weakness can indicate nerve root compression.
  • Presacral masses are rare and can present with varied neurological symptoms.

Observation:

  • A 46-year-old patient presented with a three-year history of nocturnal sciatica and left lower extremity motor weakness.
  • Neurologic examination revealed deficits in the left L5 and S1 nerve roots.
  • CT imaging identified a small presacral mass compressing these nerve roots.

Findings:

  • CT-guided fine needle aspiration revealed benign mesenchymal cells, consistent with a neurinoma.
  • The tumor was located between the L5 and S1 nerve roots.

Implications:

Related Experiment Videos

  • Neurinomas causing neurological deficits typically require surgical exstirpation.
  • Early diagnosis and intervention are crucial for managing nerve compression.
  • Patient-specific factors, like symptom severity, influence treatment decisions.