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60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Catamenial syndrome involving the sciatic nerve – a case report

Meeting Abstract

  • C. Heinen - Neurochirurgie Universität Ulm am BKH zu Günzburg
  • W. Börm - Neurochirurgische Klinik Diakonissenkrankenhaus Flensburg
  • C. Sommer - Neuropathologische Abteilung, Universitätsklinikum Mainz
  • R. Mangold - Gynäkologische Gemeinschaftspraxis Laupheim
  • H.-P. Richter - Neurochirurgie Universität Ulm am BKH zu Günzburg
  • G. Antoniadis - Neurochirurgie Universität Ulm am BKH zu Günzburg
  • C.R. Wirtz - Neurochirurgie Universität Ulm am BKH zu Günzburg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP15-10

DOI: 10.3205/09dgnc419, URN: urn:nbn:de:0183-09dgnc4198

Veröffentlicht: 20. Mai 2009

© 2009 Heinen et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Generally, endometriosis represents one of the most frequent benign gynecological pathologies with an incidence of 1-2. Manifestation of the disease can be observed intra- and extragenitally.

Involvement of peripheral nerves in endometriosis is a rarely occurring problem. We present a young woman suffering from an affection of the right sciatic nerve.

Methods: A 34-year-old female patient experienced a rapid onset of right-sided sciatica with consecutive paresthesia and developed an atrophy of right leg muscles. The symptoms reached a maximum at menstruation every month. During her pregnancy the problems completely disappeared. However, after giving birth to the child, deterioration took place. Multiple examinations were performed without a definitive diagnosis.

MRI of the gluteal region displayed an edema of the medial and inferior gluteal muscle, internal and external obturatorius muscle; neurologically, weakness of the peroneal and tibial nerve as well as paresthesia of the L5- and S1-dermatome was found. Neurography of the tibial nerve detected a conduction block.

Results: Suspecting a catamenial syndrome we performed a neurolysis and decompression of the right sciatic nerve at the foramen infrapiriforme. The nerve appeared to be distended and showed typical cysts with a chocolate-like content; histopathological examination revealed endometrial formations within the nerve.

Postoperatively symptoms diminished for about a year, and then new foci appeared bringing about new problems.

Conclusions: Catamenial syndrome involving peripheral nerves is a rare pathology. Only the synopsis of clinical observation, anamnesis, imaging and neurography can lead to the correct diagnosis. In women in childbearing age with unclear sciatica this possibility should be kept in mind.