Unilateral swelling of the lower abdominal wall. Unusual clinical manifestation of an upper lumbar disc herniation.
Circumscribed unilateral paralysis of abdominal muscles is a rare clinical feature and has previously been described in diabetic neuropathies and traumatic or non-traumatic compressive neuropathies. The paper describes a case presenting with transversus abdominis muscle paralysis and burning paraesthesia in the anterolateral aspect of the thigh caused by a lateral L2-L3 disc herniation. Abdominal echography and the EMG investigation led to the suspicion of a disc prolapse which was eventually verified by myelography completed with a CT scan. Surgery confirmed L2 root compression by a large calcified herniation in the intervertebral foramen L2-L3. The anatomical principles are recalled to explain the clinical manifestations.
Bartolomei
L
L
Divisione Neurologica, Ospedale Civile di Castelfranco Veneto, Italy.
Carbonin
C
C
Cagnin
G
G
Toso
V
V
D000009:Abdominal Muscles / Q000294:innervation*; D000328:Adult; D004576:Electromyography; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D009192:Myelography; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging* / Q000601:surgery; D010243:Paralysis / Q000000981:diagnostic imaging* / Q000601:surgery; D010292:Paresthesia / Q000000981:diagnostic imaging* / Q000601:surgery; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed