Phantom endometriosis of the sciatic nerve.
OBJECTIVE
To assess the efficacy and diagnostic value of GnRH agonist (GnRH-a) therapy in cases of hidden sciatic nerve endometriosis.


METHODS
Case report.


METHODS
Academic tertiary referral center for endometriosis treatment.


METHODS
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.


METHODS
Monthly administration of the GnRH-a leuprolide acetate plus daily transdermal E2 (25 microg).


METHODS
Relief of pain symptoms and improvement in motor function.


RESULTS
All three patients had clear decreases in pain and partial amelioration of claudication.


CONCLUSIONS
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.
Fedele
L
L
Department of Obstetrics and Gynecology, University of Verona, Italy.
Bianchi
S
S
Raffaelli
R
R
Zanconato
G
G
Zanette
G
G
D000279:Administration, Cutaneous; D000328:Adult; D004334:Drug Administration Schedule; D004576:Electromyography; D004715:Endometriosis / Q000175:diagnosis* / Q000503:physiopathology; D004958:Estradiol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D009068:Movement / Q000187:drug effects / Q000502:physiology; D010146:Pain / Q000503:physiopathology; D010166:Palliative Care; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012584:Sciatic Nerve / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D016729:Leuprolide