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Right-sided sciatalgia complicating Crohn's disease

J F Demarquay1, F X Caroli-Bosc, M Buckley

  • 1Department of Gastroenterology and Radiology, Archet II Hospital, C.H.U. Nice, France.

The American Journal of Gastroenterology
|November 20, 1998
PubMed
Summary
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Neurological complications from Crohn's disease are rare. This case highlights how terminal ileum inflammation can cause sciatica, resolved by surgical resection.

Area of Science:

  • Gastroenterology
  • Neurology
  • Radiology

Background:

  • Crohn's disease (CD) is a chronic inflammatory bowel disease.
  • Neurological complications are uncommon in CD, especially those involving the extradural space.

Observation:

  • A 40-year-old woman with terminal ileum Crohn's disease presented with right-sided sciatica.
  • Elevated serum fibrinogen and C-reactive protein indicated active inflammation.
  • Imaging revealed a presacral mass compressing the lumbosacral nerve.

Findings:

  • The neurological symptoms were attributed to inflammation and edema of the terminal ileum affecting the presacral space and lumbosacral nerve.
  • Surgical resection of the affected terminal ileum segment led to complete symptom resolution.

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Implications:

  • This case underscores the importance of considering extradural or nerve root compression in Crohn's disease patients with unexplained neurological deficits.
  • Advanced imaging like MRI or CT is crucial for diagnosing such rare complications.