Abstract
Objective To assess the efficacy and diagnostic value of GnRH agonist (GnRH-a) therapy in cases of hidden sciatic nerve endometriosis.
Setting Academic tertiary referral center for endometriosis treatment.
PATIENT(S): Three patients with cyclic, catamenial sciatica associated with pelvic endometriosis who had electromyographic evidence of sciatic nerve damage but negative computed tomography and magnetic resonance imaging findings.
INTERVENTION(S): Monthly administration of the GnRH-a leuprolide acetate plus daily transdermal E2 (25 microg).
MAIN OUTCOME MEASURE(S): Relief of pain symptoms and improvement in motor function.
RESULT(S): All three patients had clear decreases in pain and partial amelioration of claudication.
CONCLUSION(S): Endometriosis of the sciatic nerve may be hard to diagnose with the use of current imaging techniques but may be proved by clinical response to GnRH analogue treatment and may be more frequent than previously thought.
sciatic nerve endometriosis GnRH agonist treatment, catamenial sciatica endometriosis diagnosis, cyclic sciatica pelvic endometriosis imaging negative, Fedele sciatic nerve endometriosis phantom, leuprolide acetate add-back therapy sciatic endometriosis, endometriosis sciatic nerve electromyography diagnosis, hidden endometriosis sciatic nerve MRI negative, GnRH agonist diagnostic trial endometriosis sciatica, deep infiltrating endometriosis nerve involvement, endometriosis neuropathy treatment GnRH analogue
PMID 10521118 10521118 DOI 10.1016/s0015-0282(99)00305-2 10.1016/s0015-0282(99)00305-2
Keywords
Administration, Cutaneous, Adult, Drug Administration Schedule, Electromyography, Endometriosis/diagnosis/physiopathology, Estradiol/administration & Dosage/therapeutic Use, Female, Gonadotropin-Releasing Hormone/agonists, Humans, Leuprolide/administration & Dosage/therapeutic Use, Magnetic Resonance Imaging, Movement/drug Effects/physiology, Pain/physiopathology, Palliative Care, Peripheral Nervous System Diseases/diagnosis/physiopathology, Sciatic Nerve/physiopathology, Tomography, X-Ray Computed, Gonadotropin-Releasing Hormone, Estradiol, Leuprolide