Ueta Yuki, Kimura Takayuki, Fujimori Koji, Yunaiyama Daisuke, Taguchi Takeshi, Terashi Hiroo
Department of Neurology, Tokyo Medical University Hachioji Medical Center.
Department of Neurology, Tokyo Medical University.
Rinsho Shinkeigaku. 2023 Oct 25;63(10):676-679. doi: 10.5692/clinicalneurol.cn-001892. Epub 2023 Sep 30.
We report the case of a 40-year-old woman, with endometriosis, who presented with a history of foot drop and cyclic sensory disturbance of the right lower limb. She was initially diagnosed with lumbar disc herniation. Neurological examination revealed muscle weakness and sensory disturbance associated with the right sciatic nerve. Nerve conduction studies revealed a low amplitude sensory nerve action potential in the right superficial fibular and sural nerves. Pelvic magnetic resonance imaging revealed an endometriotic cyst in the right ovary, and an endometriotic lesion extending from the right ovary, pelvis, and the right sciatic nerve. Though her symptoms moderately improved with hormonal therapy, the foot drop remained. Our case and previous reports suggest that endometriosis with sciatic neuropathy shows cyclic neurological symptoms during menstruation, with a higher incidence on the right extremity. This case highlights that endometriosis should be considered as a potential differential diagnosis in women of reproductive age with sciatic nerve dysfunction. Its cyclic neurological manifestations should be investigated.
我们报告了一例40岁患有子宫内膜异位症的女性病例，该患者有足下垂和右下肢周期性感觉障碍病史。她最初被诊断为腰椎间盘突出症。神经学检查发现与右侧坐骨神经相关的肌肉无力和感觉障碍。神经传导研究显示右侧腓浅神经和腓肠神经的感觉神经动作电位幅度降低。盆腔磁共振成像显示右侧卵巢有一个子宫内膜异位囊肿，并且有一个子宫内膜异位病灶从右侧卵巢延伸至盆腔和右侧坐骨神经。尽管她的症状通过激素治疗有一定程度改善，但足下垂仍然存在。我们的病例以及之前的报告表明，伴有坐骨神经病变的子宫内膜异位症在月经期间会出现周期性神经症状，右侧肢体的发病率更高。该病例强调，对于有坐骨神经功能障碍的育龄女性，应将子宫内膜异位症视为一种潜在的鉴别诊断疾病。应调查其周期性神经表现。
