ABSTRACT
Idiopathic lumbosacral plexopathy is an uncommon idiopathic disorder characterized by acute onset of severe lower extremity pain, followed by weakness, atrophy of affected muscle, and variable sensory disturbance. A 61-year-old man experienced sudden onset of dysesthesia with weakness in right lower extremity. Electrodiagnostic study revealed patch pattern denervation at L3 and L4 root without paraspinal muscle involvement. Lumbar MRI showed abnormal signals in the right lumbar plexus. Pulse intravenous administration of high-dose immunoglobulin alleviated the sensorimotor symptoms. Abnormal signals in lumbar MRI reduced 6 months later.
Subject(s)
Humans , Middle Aged , Administration, Intravenous , Atrophy , Denervation , Immunoglobulins , Lower Extremity , Lumbosacral Plexus , Muscles , ParesthesiaABSTRACT
A 57-year-old man presented with weakness in both legs upon awakening after drinking. Magnetic resonance imaging (MRI) of the lumbar spine did not reveal any intraspinal abnormalities but MRI of the pelvis revealed lesions with abnormal intensities with heterogeneous contrast enhancement in both gluteal muscles. Serum creatine phosphokinase was markedly elevated. A diagnosis of lumbosacral plexopathy, complicating rhabdomyolysis was made. With supportive care he recovered well but mild weakness of the right ankle remained at 6 month-follow-up. Pelvic MRI is a helpful diagnostic tool in localizing rhabdomyolysis. Lumbosacral plexopathy should be included in the differential diagnosis of the such cases, presenting with sudden weakness of legs.
Subject(s)
Humans , Middle Aged , Ankle , Creatine Kinase , Diagnosis , Diagnosis, Differential , Drinking , Leg , Magnetic Resonance Imaging , Muscles , Pelvis , Rhabdomyolysis , SpineABSTRACT
The neuropathic pain caused by lumbosacral plexopathy as a sequela to extensive pelvic and sacral fractures is rare because many posttraumatic cases remain undiagnosed as a result of the high mortality associated with these types of injury and because of the survivors of multiple trauma, including pelvic fractures, frequently have an incomplete work-up. Although surgical treatments for medically refractory lumbosacral plexus avulsion pain have been reported, an effective surgical technique for pain relief in lumbosacral plexopathy has not been well documented. We describe the effectiveness of spinal cord stimulation (SCS) in a patient suffering from severe neuropathic pain caused by lumbosacral plexopathy after an extensive pelvic fracture.
Subject(s)
Humans , Lumbosacral Plexus , Mortality , Multiple Trauma , Neuralgia , Spinal Cord Stimulation , Spinal Cord , SurvivorsABSTRACT
The neuropathic pain caused by lumbosacral plexopathy as a sequela to extensive pelvic and sacral fractures is rare because many posttraumatic cases remain undiagnosed as a result of the high mortality associated with these types of injury and because of the survivors of multiple trauma, including pelvic fractures, frequently have an incomplete work-up. Although surgical treatments for medically refractory lumbosacral plexus avulsion pain have been reported, an effective surgical technique for pain relief in lumbosacral plexopathy has not been well documented. We describe the effectiveness of spinal cord stimulation (SCS) in a patient suffering from severe neuropathic pain caused by lumbosacral plexopathy after an extensive pelvic fracture.