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At least 145 records · Page 8Linked to original sources
PubMed2000

Recurrent idiopathic lumbosacral plexopathy.

Recurrent idiopathic lumbosacral plexopathy has rarely been reported in the literature. The present report describes a 59-year-old man presenting with recurrent episodes of acute leg pain, followed by weakness. After each episode, symptoms progressed for several months before peaking. Thereafter, gradual recovery ensued. Electrodiagnostic studies revealed primarily a patchy pattern of denervation in the distribution of part of the lumbosacral plexus, sparing the paraspinal muscles. Extensive evaluations for an underlying cause were unrevealing. Thus, these episodes are suggestive of recurrent idiopathic lumbosacral plexopathy, and the present case is compared with previous cases reported in the literature.

Denervation↗
PubMed1996

[Rhabdomyolysis and lumbosacral plexopathy in intravenous drug addict: report of a case].

There are several neuromuscular complications in the intravenous heroin addict (IHA). Someone may be due to direct toxic effect of the substance, but other ones may be associated to abuser's typical diseases (i.e. HIV infection). We present a 27 year-old IHA patient, HIV positive, that develop acute rhabdomyolisis with severe neuromuscular involvement, and consistent clinical and electrodiagnostic features of lumbosacral plexus neuropathy, forteen hours after an heroin inyection. Thirty months later, the patient is severely disabled, but her initial painfull and paretic picture have improved. The association of rhabdomyolisis-lumbosacral plexopathy (RLPS) is ocasionally reported. It has been proposed that RLSP is etiologically related to mecanic, toxic and immunologic factors.

Adult↗
PubMed1987

Gastric partitioning complicated by peripheral neuropathy with lumbosacral plexopathy.

Gastric bypass and partitioning are the two surgical procedures most commonly used in the treatment of morbid obesity. They are, however, not without their postoperative complications. These include acute and chronic problems such as wound infection, gastric leak, obstruction, embolism, and neurologic sequelae. Many studies have mentioned the frequent occurrence of polyneuropathy in the postgastrectomy state. This report describes a 38-year-old patient who developed an asymmetric peripheral neuropathy with lumbosacral plexus involvement following gastric bypass surgery for morbid obesity.

Adult↗
PubMed2001

Tracing of proximal lumbosacral nerve conduction--a comparison of simultaneous magneto- and electroneurography.

OBJECTIVE: The reconstruction of nerve impulse conduction along proximal lumbosacral plexus and nerve roots is compared using simultaneous magneto- and electroneurography. METHODS: In 3 healthy subjects the left tibial nerve was electrostimulated at the ankle. Evoked magnetic fields and electric surface potentials were measured simultaneously over the lumbosacral spine using a multichannel SQUID-detector with a planar measuring area and 25 surface electrodes covering a comparable area centered around L4. Based on either magnetic field or electric potential maps the depolarization front of the evoked compound action currents (CAC) was spatio-temporally reconstructed using a simple equivalent current dipole model in a half-space volume conductor. RESULTS: The mean signal-to-noise ratio in the magnetic (electric) recordings was around 4 (8). Yet, the localization quality for the propagating CAC was lower for electric than magnetic recordings. The local nerve conduction velocity was around 47 m/s (calculated from magnetic data), but fluctuated unphysiologically for electric data. CONCLUSION: In comparison to electroneurography, an anatomically reasonable localization of evoked compound action currents propagating in lumbosacral roots can be obtained by magnetoneurography.

Adult↗
PubMed1990

Neurologic deficits associated with sacral wing fractures.

Twelve of 96 patients with pelvic fractures suffered neurologic deficits. Four secondary to acetabular fractures were excluded from the study. Of the remaining eight, five were found by CT scan to be secondary to fractures of the sacral wing extending through the sacral foramina. On the basis of this study, it is believed that the neurologic injuries were due to sacral root injuries rather than lumbosacral plexus injuries. This concept potentially could lead to surgical approaches for decompression of sacral root trauma.

Adolescent↗
PubMed1984

Intrapartum maternal lumbosacral plexopathy.

Maternal intrapartum neurologic injuries are infrequently reported in modern obstetric practice. Two cases are presented and methods of evaluating the level of injury to differentiate this syndrome from peroneal nerve palsies are suggested. The long-term prognosis of lumbosacral plexus injuries encountered during labor and delivery appears to be favorable. Nonetheless, future intrapartum management of these patients should be conservative.

Adult↗
PubMed1994

Lumbosacral plexopathy in the third trimester of pregnancy: a report of three cases.

Lumbosacral plexopathy was diagnosed in three patients in the third part of pregnancy. Symptoms started with acute pain in the groin and/or the lower part of the back around 33 weeks amenorrhoea. Neurological symptoms were absent before pregnancy. Denervation activity occurred in the muscles innervated by the upper part of the lumbosacral plexus. The exact etiology is not known although pressure on the plexus by fetal parts may be involved. Recovery may require months but the injury is self-limiting and the prognosis is favourable.

Adult↗
PubMed2006

Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity.

Neoplastic lumbosacral plexopathy occurs with some abdominal and pelvic malignancies. Patients present with severe pain radiating from the low back down to the lower extremities, and this progresses to weakness. Neoplastic lumbosacral plexopathy is virtually always associated with known malignancy or obvious pelvic metastatic disease. Uncommonly, prostate cancer can present as a lumbosacral plexopathy occurring through direct pelvic spread. We describe two cases of lumbosacral radiculoplexopathy from infiltrative prostate cancer without evidence of other pelvic or extraprostatic spread. The probable etiology of tumor spreading along prostatic nerves into the lumbosacral plexus (i.e., perineural spread) is discussed as are the potential mechanisms for this unusual mode of cancer dissemination.

Aged↗
PubMed1990

Acute lumbosacral plexopathy in diabetic women after renal transplantation.

Renal transplantation is an accepted treatment for patients with end stage renal disease from insulin-dependent diabetes mellitus. Acute lumbosacral plexopathy developed following renal transplantation in 4 female patients with insulin-dependent diabetes mellitus between January 1, 1981 and June 30, 1988. In all 4 patients the internal iliac artery was used for revascularization of the renal allograft with ligation of the anterior and posterior divisions. Within 24 hours of surgery they complained of ipsilateral buttock pain, numbness in the leg and weakness below the knee. This complication has not been observed in nondiabetic patients at our institution, nor in diabetic patients when the internal iliac artery was not used. However, lumbosacral plexopathy occurred in 4 of 27 (14.8%) female patients with insulin-dependent diabetes mellitus when the internal iliac artery was used (p less than 0.001). Age, duration of insulin-dependent diabetes mellitus, hypertension, cigarette smoking history and kidney donor were not significant predictors of this complication. This unusual and newly recognized complication appears to result from ischemia of the lumbosacral plexus following ligation of the internal iliac artery in patients with severe small vessel disease.

Acute Disease↗
PubMedDate not supplied

["Lumbar intervertebral disk-induced sciatica" diagnostic error in extensive extra- and intrapelvic lipoma].

PURPOSE: The aim of this study is to demonstrate the importance of the differential diagnosis of sciatica. Radiculopathy in the lower extremity of an adult usually originates from a herniated nucleus pulposus. In this paper an extraspinal cause of sciatica due to a pelvic tumor is reported, which is initially often not recognized. METHODS AND RESULTS: A 67-year old woman suffered from sciatica. After one year of unsuccessful conservative treatment and beginning weakness of hip flexion a computed tomography of the pelvis revealed a giant lipoma with compression of the lumbosacral plexus. CONCLUSIONS: The results of this case illustrate the problem of over-rating CT-findings of the lumbar intervertebral disks in patients with sciatica. Extraspinal tumorous causes of radiculopathy are rare, but should be considered if the therapeutical measures are resistant to treatment. Computed tomography and magnetic resonance imaging are most useful in confirming a retroperitoneal tumor causing lumbosacral radiculopathy.

Adult↗
PubMedDate not supplied

[Lumbar plexopathy secondary to pelvic hydatid cyst].

INTRODUCTION: Hydatidosis is a zoonosis caused by larvae of the hydatid tapeworm Echinococcus granulosus, which usually affects the liver, lung, myocardium, brain and bones. On rare occasions hydatid cysts give rise to peripheral neurological manifestations. CASE REPORT: Male, aged 72, who had received a pacemaker as a consequence of a complete auriculoventricular block. During implantation, one hepatic and two pelvic hydatid cysts were discovered. Consulted doctor about right inguinal pain, which irradiated to the lumbar region and along the inner and posterior sides of the thigh, down to the ankle. Exploration revealed a lump in the right iliac fossa and in the lower right limb, hypaesthesia in the anterior side of the thigh, paresis on bending the hip and on extension of the knee, and patellar areflexia. Computerised axial tomography revealed growth of the pelvic cysts and compression of the gluteal veins. Electromyographic exploration of the right quadriceps showed denervation and reinnervation activity. CONCLUSION: Of all cases of abdominal hydatidosis, 6.7% presented extra hepatic affectation and only 0.7% were seen to have pelvic hydatid cysts. These usually give rise to disorders due to local compression of the genital organs, the urinary tracts, and vascular and bony structures. Lesions in the lumbosacral plexus, however, have only been reported on very few occasions

Aged↗
PubMed1998

Transverse subgluteal-ilioinguinal approach to the acetabulum.

An approach to the acetabulum is described. This approach consists of an anterior and a posterior part. The anterior part is nearly identical with the ilioinguinal approach. The posterior part resembles Kocher's (Gibson, J Bone Joint Surg 1950;32B:183-186) original description in that the plane of dissection passes between the motor territories of the superior gluteal nerve anterolaterally and the inferior gluteal nerve posteromedially. Two modifications have been introduced, however. First, the incision is a transverse one; superior and inferior fasciocutaneous flaps are elevated. Second, the gluteus maximus is not only disinserted from the fascia lata and the gluteal tuberosity at the upper end of the femur but from the iliac crest as well. After ligating the superficial branch of the superior gluteal artery to the gluteus maximus, the muscle itself is reflected posteromedially. We have used this approach to explore the lumbosacral plexus and its branches, particularly the sciatic nerve at the greater sciatic notch. Due to the excellent exposure of both columns of the acetabulm, this approach may be equally used in fractures of the acetabulum.

Acetabulum↗
PubMed1993

Palliative-radiotherapy in lumbosacral carcinomatous neuropathy.

The authors report their own experience in obtaining pain relief in 13 recurrent or disseminated cancer patients affected by lumbosacral carcinomatous neuropathy (LCN). The site, where the disease involved the lumbosacral plexus or its branches, was palliatively irradiated with a few large fractions. The average duration of response was 196 days. Median survival (uncensored) was 185 days (range 47-636 days).

Adult↗
PubMed1984

Subtle neurological injuries in pelvic fractures.

Eleven of 28 patients with a fracture of the acetabulum, pelvis, or sacrum were found to have electromyographic changes, apparently due to injury to the lumbosacral plexus. There appears to be a higher incidence associated with sacral fracture or sacroiliac separation (64%) than with acetabular fracture (24%). The EMG changes are diffuse and the clinical manifestations are subtle but the changes do interfere with the rehabilitation process.

Acetabulum↗
PubMed1996

Fecal incontinence after pelvic radiotherapy: evidences for a lumbosacral plexopathy. Report of a case.

PURPOSE: Clinical manifestations of radiation-induced lumbosacral plexopathy remain a rare event. We report the case of a 62-year-old woman with neurogenic fecal incontinence that occurred after radiotherapy of cervical carcinoma. METHODS: Anorectal, bladder, and lower limb sensory-motor functions, as biologic and morphologic explorations, were performed on repeated occasions. RESULTS: Anorectal manometry, conduction times of pudendal nerves, sacral latencies, and pudendal nerve-evoked corticals disclosed lesions of the lumbosacral plexus that was confirmed by bladder manometry and electromyography of lower limbs. Biologic and morphologic explorations were within normal ranges. CONCLUSION: Because no other cause except radiation was demonstrated in this case, we suggest that plexopathy may be a late-occurring complication of radiotherapy.

Brachytherapy↗
PubMed1981

[3 cases of paraneoplastic syndrome caused by lymphoma of the small intestine].

Three cases of lymphoma of the small intestine accompanied by numerous aspecific signs related to probable paraneoplastic syndromes are reported. All patients presented watch glass nails and drumstick fingers. These were associated, in the first patient, with initial pruritus followed by a picture of ichthyosis and, in the second, with a polyneuritic syndrome localised initially at the nerves of the lumbosacral plexus, later extended to the right facial nerve. The practical importance of such signs, which often precede and dominate, at least initially, symptomatology in the gastroenteric apparatus, is pointed out. Their early recognition may lead to a suspicion of the fundamental condition, thus avoiding diagnostic errors and permitting earlier diagnosis and faster treatment.

Adult↗
PubMed1984

Diagnosis and treatment of lumbosacral plexopathies in patients with cancer.

Eleven patients were diagnosed as having lumbosacral plexopathy at M. D. Anderson Hospital, Houston, from August 1981 through July 1982. Four causes were documented: plexopathy secondary to metastatic disease (six cases); radiation-induced plexopathy (two cases); plexopathy secondary to intra-arterial chemotherapy (two cases); and plexopathy as the result of a second primary tumor (one case). Patients with plexopathies secondary to tumor or irradiation complained of pain in the ipsilateral lower extremity. Computed tomography of the pelvis was the most accurate method of documenting tumor in the region of the lumbosacral plexus. Radiation therapy records of patients with cervical carcinoma were reviewed with respect to positioning of intracavitary radium, which was thought to be responsible for the development of radiation-induced plexopathies. Radiation therapy and/or systemic chemotherapy provided relief of pain and improvement of neurologic deficits in three patients with metastatic involvement.

Adult↗