Catamenial mononeuropathy and radiculopathy: a treatable neuropathic disorder

• Published in: Journal of neurosurgery Vol. 88; no. 5; p. 827
• Main Authors: Zager, E L, Pfeifer, S M, Brown, M J, Torosian, M H, Hackney, D B
• Format: Journal Article
• Language: English
• Published: United States 01.05.1998
• Subjects: Adult; Analgesics - therapeutic use; Anti-Inflammatory Agents - therapeutic use; Antineoplastic Agents, Hormonal - therapeutic use; Endometriosis - complications; Female; Femoral Nerve - pathology; Humans; Hypesthesia - etiology; Hypesthesia - therapy; Laparoscopy; Leuprolide - therapeutic use; Low Back Pain - etiology; Low Back Pain - therapy; Lumbosacral Plexus - pathology; Menstruation; Middle Aged; Muscle Weakness - etiology; Muscle Weakness - therapy; Muscular Diseases - complications; Neuralgia - etiology; Neuralgia - therapy; Paresthesia - etiology; Paresthesia - therapy; Peripheral Nervous System Diseases - diagnostic imaging; Peripheral Nervous System Diseases - etiology; Peripheral Nervous System Diseases - pathology; Peripheral Nervous System Diseases - therapy; Physical Therapy Modalities; Radiography; Sciatic Nerve - pathology; Sciatica - diagnostic imaging; Sciatica - etiology; Sciatica - pathology; Sciatica - therapy; Spinal Nerve Roots - diagnostic imaging; Spinal Nerve Roots - pathology; Thigh - innervation; Treatment Outcome
• ISSN: 0022-3085
• DOI: 10.3171/jns.1998.88.5.0827

The aim of this study was to investigate the indications and treatment options in patients with lower-extremity neuropathies and radiculopathies caused by endometriosis. The authors identified five patients whose symptoms included catamenial pain, weakness, and sensory loss involving the sciatic and femoral nerves and multiple lumbosacral nerve roots. Radiographic studies supported the diagnosis of catamenial neuropathy or radiculopathy, but definitive diagnosis depended on surgical and pathological examination. Treatment of symptoms, including physical therapy and a course of antiinflammatory or analgesic medication, was not helpful. Patients responded favorably to hormonal therapy. Laparoscopy or open exploration for extrapelvic lesions was performed for diagnosis or for treatment when hormone therapy failed. Pain and sensory symptoms responded well to therapy. Weakness improved, but never recovered completely. Catamenial neuropathy or radiculopathy should be considered when evaluating reproductive-age women with recurring focal neuropathic leg pain, weakness, and sensory loss.