Sciatic neuropathy (SN) is a result of nerve injury or compression anywhere along the route of the nerve from the lumbosacral region to its bifurcation in the posterior aspect of the thigh. Accidental (hip fracture, dislocation, penetrating wounds) or iatrogenic (intramuscular injections) trauma, tumors, ischemia, and compression (hematomas, compression syndrome) can cause this condition [1] [2] [3]. Piriformis syndrome is another rare etiologic factor of SN. As compression neuropathy is seen during pregnancy, prolonged lithotomy position can lead to piriformis syndrome and consequently SN [4].

Patients with SN typically present with lower extremity pain and paresthesias. Other symptoms depend on the level at which the sciatic nerve is affected. If the lesion is proximal then genuflexion is difficult, with a loss of foot dorsiflexion (flail foot), and plantarflexion [3]. There may be a loss of sensations if the lesion involves the posterior aspect of the thigh and the foot [3]. Patients may be able to flex and extend their knee in hamstring sparring injuries of the nerve, although their gait will be impaired by their inability to plantarflex and dorsiflex [3]. Injuries in the distal part of the nerve give rise to neurological deficits similar to those seen in other mononeuropathies or lumbosacral radiculopathies [5].

Children, when suffering from SN, present with weakness of the tibialis anterior and gastrocnemius muscles [6]. However, SN occurs rarely in this age group.

• Lower Extremity Pain

  Patients with SN typically present with lower extremity pain and paresthesias. Other symptoms depend on the level at which the sciatic nerve is affected. [symptoma.com]

  cramps, and weakness in the left lower extremity. [ncbi.nlm.nih.gov]

• Weight Gain

  For example, if weight gain is the underlying cause, then a weight loss program is the most appropriate treatment. Compression neuropathy occurring in pregnancy often resolves after delivery, so no specific treatment is usually required. [en.wikipedia.org]

• Low Back Pain

  She denied any associated low back or left lower limb pain. The patient was initially treated for a probable right lumbosacral radiculopathy, without improvement. [ncbi.nlm.nih.gov]

  Easy exercise program for low back pain relief <ul><li>1. [slideshare.net]

  He complained of low back pain, left buttock pain, and left leg numbness and weakness. The left hamstring, anterior tibial, and gastrocnemius muscles were markedly weak (0-1/5). [jamanetwork.com]

  American Association of Neurological Surgeons: "Low Back Pain." American Pregnancy Association: "Pregnancy and Sciatic Nerve Pain." American College of Obstetricians and Gynecologists: "You and Your Baby." [webmd.com]

  A guide to buttock and leg pain (which may or may not involve the sciatic nerve) If you mainly have low back pain, please change articles: you need to be reading Save Yourself from Low Back Pain! [painscience.com]

• Thigh Pain

  Case presentation A 47-year old with a large right lower extremity AVM, identified during evaluation for exertional hip and thigh pain, underwent her fourth endovascular procedure. [jbppni.biomedcentral.com]

  Symptoms of Sciatica Buttock pain Pain in the thigh Pain in the lower leg or foot Weakness in the leg or foot (foot drop) Although the term sciatica means there is inflammation to the nerve, the most common cause of the inflammation is pressure and irritation [olympicspine.com]

• Sciatica

  Here are a few common causes for sciatica: Spinal disc herniation is present in nearly 90% of all sciatica cases. This occurs when the herniated disc is pressing on a lumbar nerve. [neuropathytreatmentgroup.com]

  Prognosis The prognosis for the pain relief of most cases of sciatica is excellent. With a combined use of anti-inflammatory drugs and mild exercise, such as walking, sciatica can be reduced and even eliminated. [encyclopedia.com]

• Tingling

  We report the case of a 55-yr-old woman with a history of chronic low back pain who presented with progressive right buttock and posterolateral right lower limb pain associated with right foot numbness and tingling. [ncbi.nlm.nih.gov]

  • Leg weakness • Muscle thinning or atrophy • Tingling sensation (pins and needles) • Numb feeling • Difficulty with waling etc. [your-neurologist.com]

  Neurostimulation (physiotherapy) eliminates crawling, tingling, pain and Silences, regains power in the muscles in the treatment of the sciatic nerve neuropathy (neuritis). [minclinic.ru]

  The numbness and tingling often follows a pattern with this problem. Numbness from an irritated sciatic nerve commonly follows the line of the nerve root called a dermatome. [lower-back-pain-toolkit.com]

• Foot Drop

  Overview Sciatic neuropathy is an important consideration in the patient with foot drop. [medlink.com]

  Pain and weakness, primarily foot drop, were the most common presenting symptoms. [ncbi.nlm.nih.gov]

  […] case report. 61 Ko JU...Park D 30212953 2018 10 A Central Nervous System Tumor Mimicking a Lumbar Spine Pathology Causing Acute Foot Drop: A Case Report. 61 Dolev A...Yassin M 30740383 2018 11 Post-operative extra-spinal etiologies of sciatic nerve impingement [malacards.org]

• Radiculopathy

  It is important to differentiate between SN, radiculopathies, and plexopathies as they all present with identical symptoms. [symptoma.com]

  Weak Hip abduction Strong Weak Ankle DTR Present Absent Bilateral footdrop (causes): 1) Peripheral neuropathy 2) Bilateral radiculopathy- Bil L5 radiculopathy OR more usually.. 3) Cauda equina syndrome (LMN lesion) / Conus medullaris syndrome (mixed [one.wikia.com]

  The patient was initially treated for a probable right lumbosacral radiculopathy, without improvement. [ncbi.nlm.nih.gov]

  Completed NCT01917825 Phase 2 MDT-15 25 BG00010 (Neublastin) Phase 2 Multiple Dose Adaptive Design in Participants With Painful Lumbar Radiculopathy Completed NCT01873404 Phase 2 BG00010;Placebo 26 Magnets in the Treatment of Sciatica Completed NCT00044109 [malacards.org]

• Mononeuropathy

  Causes of this mononeuropathy include total hip arthroplasty, unusual forms of leg or buttock compression, neoplasms, and a heterogeneous group of other disorders. [medlink.com]

  Injuries in the distal part of the nerve give rise to neurological deficits similar to those seen in other mononeuropathies or lumbosacral radiculopathies. [symptoma.com]

  There is a possibility that our patient could have a compressive sciatic nerve mononeuropathy. [pediatricneurosciences.com]

  Introduction Sciatic neuropathy is an uncommonly diagnosed focal mononeuropathy. Causes may include trauma, diabetic mononeuropathy, intragluteal injections, gluteal spontaneous haemorrhage or piriformis syndrome (1,2). [jneuro.com]

SN workup includes a detailed history along with a thorough clinical and neurological examination which will reveal a weakness of the tibialis anterior and/or gastrocnemius muscle. It is important to differentiate between SN, radiculopathies, and plexopathies as they all present with identical symptoms.

However electrodiagnostic tests such as electromyography and nerve conduction velocity test (NCV) are necessary to confirm the diagnosis and to provide information regarding prognosis [7]. They are also useful if the examination findings are inconclusive or if sensory deficits cannot be elicited e.g. in children. NCV are normal in radiculopathies but altered or abnormal in SN [5]. Motor unit amplitude, arrangement, and duration are useful to determine whether SN has been long-standing [5]. For the diagnosis of SN in children, electrophysiologic findings along the peroneal as well as the tibial and sural nerve distribution should be performed with or without electromyography in the muscles innervated by the tibial nerve [6].

Magnetic resonance imaging (MRI) or neurography and ultrasonography are some of the radiological tests performed in the workup of SN. Neuropathy findings on MRI include expansion of the nerve with variation in its course and elevated signal intensity and contrast enhancement. In patients with sciatic nerve compression, there may be edema in the vicinity of the nerve around the ischial tuberosity [8] MRI can also help to detect other lesions like tumors.

The patient was transferred to the department of gastroenterology for the treatment of toxic hepatitis, which occurred during her inpatient treatment. [ncbi.nlm.nih.gov]

Treatment options of sciatic nerve neuropathy (neuritis) chosen individually in each case. [minclinic.ru]

Treatment The immediate treatment of most cases of sciatica is to recommend medications specific to the inflammation. Staying active is also highly recommended, while avoiding activities that put pressure on the back. [encyclopedia.com]

- Nerve Palsy Associated with Total Hip Arthroplasty - The frequency, prognosis and significance of nerve injuries in total hip arthroplasty - females seem to be at significantly higher risk; - sciatic and superior gluteal nerve and vessels course opposite [wheelessonline.com]

The prognosis for sciatic nerve recovery was good among children who survived their associated cancer. Three children died from the cancer or complications of treatment. [ncbi.nlm.nih.gov]

Key words Sciatic neuropathy, compartment syndrome, electrophysiological studies, prognosis. Introduction Sciatic neuropathy is an uncommonly diagnosed focal mononeuropathy. [jneuro.com]

Unexpectedly, PNB was the third most common etiology (16%, n = 7). Our results suggest PNB is a relatively common etiology of sciatic neuropathy and is an important consideration in the differential diagnosis. [ncbi.nlm.nih.gov]

In this update, the authors summarize the clinical, etiologic, diagnostic, and management issues regarding sciatic neuropathy. [medlink.com]

Etiologies of sciatic neuropathy may include traumatic, compressive, ischemic, neoplastic or idiopathic factors. [scopemed.org]

Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [amjorthopedics.com]

Guidance on the management of pain in older people This guidance reviews the epidemiology and management of pain in older people via a literature review of published research. [evidence.nhs.uk]

Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654-62. [spine-health.com]

Epidemiology [ 3 ] An incidence has been estimated at 4.3 per 10,000 person years. It occurs most commonly in people between the ages of 30 to 40 years. The condition is thought to be much rarer in children. [patient.info]

We describe a patient who developed post-radiation sciatic neuropathy after approximately 3 years and discuss the pathophysiology, clinical course and treatment options available for the deleterious effects of radiation to peripheral nerves. [ncbi.nlm.nih.gov]

This article reviews the anatomy, clinical features, pathophysiology, and electrodiagnostic assessment of sciatic neuropathies. [semanticscholar.org]

Pathophysiology [ edit ] External pressure reduces flow in the vessels supplying the nerve with blood (the vasa nervorum ). This causes local ischaemia, which has an immediate effect on the ability of the nerve axons to transmit action potentials. [en.wikipedia.org]

The acuity and severity of the lesion are consistent with either of these pathophysiologies. The sciatic nerve is supplied by vessels ultimately derived from the internal iliac artery. [jbppni.biomedcentral.com]

The pathophysiology of neuropathic pain is so complicated that it is not fully understood [4]. Neuropathic pain may develop because of sciatic nerve injury. [hindawi.com]

A heightened awareness of sciatic nerve injury during prolonged surgery in the sitting position may make early diagnosis possible and allow prevention of further neurologic injury. [ncbi.nlm.nih.gov]

Prevention of Hepatitis A Through Active or Passive Immunization 19 May 2006 - Publisher: Centers for Disease Control and Prevention Routine vaccination of children is an effective way to reduce hepatitis A incidence in the United States. [evidence.nhs.uk]

Shingles can cause peripheral neuropathy, but the vaccine can prevent more than 95% of shingles cases. [es.aurorahealthcare.org]

What makes it last longer is not entirely understood, but researchers suspect that stress, mood changes, and the fear of further injury may prevent patients from being active and exacerbate the pain. [dramandakiliandctulsa.com]

1. Yuen EC, So YT. Entrapment and other focal neuropathies: sciatic neuropathy. Neurol Clin. 1999; 17(3):617–631
2. Plewnia C, Wallace C, Zochodne D. Traumatic sciatic neuropathy: a novel cause, local experience and a review of the literature. J Trauma. 1999;47(5):986–999
3. Kim DH, Murovic JA, Tiel R, Kline DG. Management and outcomes in 353 surgically treated sciatic nerve lesions. J Neurosurg. 2004; 101:8–17
4. Altintaş A, Gündüz A, Kantarci F, Gözübatık Çelik G, Koçer N, Kızıltan ME. Sciatic neuropathy developed after injection during curettage. Agri. 2016;28(1):46–48
5. Feinberg J, Sethi S. Sciatic Neuropathy: Case Report and Discussion of the Literature on Postoperative Sciatic Neuropathy and Sciatic Nerve Tumors. HSS J. 2006 Sep; 2(2): 181–187
6. Srinivasan J, Ryan MM, Escolar DM, et al. Pediatric sciatic neuropathies.Neurology. 2011 Mar 15; 76(11): 976–980
7. Kimura J. Peripheral nerve diseases. Amsterdam. Elsevier; 2006
8. Mumby DM, Hartsilver EL. Magnetic resonance imaging of sciatic nerve compression injury after epidural blockade. Int J Obstet Anesth. 2012;21(2):199–200