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Cyclic sciatica. A case report
1Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.
Spine
|January 1, 1994
Summary
Pelvic endometrioma can cause periodic sciatica linked to menstruation. Hormonal therapy effectively resolved symptoms, highlighting endometrioma as a key differential diagnosis for cyclic sciatica.
Area of Science:
- Gynecology
- Neurology
- Oncology
Background:
- Endometrioma, a condition involving endometrial tissue outside the uterus, can occur in the pelvic cavity.
- Sciatica, characterized by pain radiating along the sciatic nerve, typically originates from spinal issues.
- Cyclic sciatica, pain that correlates with the menstrual cycle, is less common and requires specific diagnostic considerations.
Observation:
- A 41-year-old woman experienced recurrent sciatica exclusively during her menstrual periods.
- Pelvic computed tomography revealed an oval mass compressing the right sciatic nerve.
Findings:
- Hormonal therapy, specifically buserelin acetate nasal spray, was administered to temporarily halt menstruation for diagnostic purposes.
- Complete resolution of sciatica symptoms following the hormonal therapy strongly suggested endometrioma as the cause.
Implications:
- This case underscores the importance of considering pelvic endometrioma in the differential diagnosis of cyclic sciatica.
- Orthopedic surgeons should evaluate for gynecological causes when sciatica exhibits a clear temporal relationship with menstruation.
- Early diagnosis and appropriate management of endometrioma can alleviate debilitating symptoms and improve patient quality of life.