title: Electromyographic Abnormalities Associated with Symptomatic Sacral Tarlov Cysts.
abstract: Tarlov or perineural cysts (TC) are commonly overlooked as a cause of sacral and ischial pain, and urogenital and bowel problems. TC can be seen on MRI, but are often considered asymptomatic. This is especially true for smaller cysts. Moreover, there are only few diagnostic characteristics that can be used to confirm that the cysts are the cause of the symptoms. As a consequence, a lot of controversy remains regarding the clinical importance of TC. Because of this underdiagnosed condition, patients often suffer for several years from unrecognized chronic neuropathic pain and neurological conditions. In this article, case reports of three patients with giant and smaller symptomatic sacral cysts are presented, in which electromyographic testing was performed to demonstrate nerve damage. We suggest that electromyography of the sacral nerve roots can be a reasonable tool for the diagnosis of symptomatic TC, as well as for the differentiation from other pathological entities causing sacral and ischial pain. Moreover, using electromyography it was also documented that smaller cysts of < 1 cm can cause nerve damage. Therefore incidence of symptomatic TC may be higher than initially thought.
authors.affiliation: Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: Hulens
authors.affiliation: Clinical Electromyography Laboratory, University Hospitals, Leuven, Belgium.
authors.forename: Frans
authors.initials: F
authors.lastname: Bruyninckx
authors.affiliation: Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Dankaerts
authors.affiliation: Department of Social and Primary Health Care, Public Health Nutrition, University of Leuven, Leuven, Belgium.
authors.forename: Greet
authors.initials: G
authors.lastname: Vansant
authors.affiliation: Department of Pain Therapy, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Peter A
authors.initials: PA
authors.lastname: De Mulder
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology; D004568:Electrodiagnosis; D004576:Electromyography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D009431:Neural Conduction; D009437:Neuralgia / Q000209:etiology; D019635:Neurosurgical Procedures; D012445:Sacrococcygeal Region; D013126:Spinal Nerve Roots / Q000503:physiopathology; D052958:Tarlov Cysts / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D000701:Analgesics, Opioid
keywords: Tarlov cysts; electromyographic testing; electromyography; pelvic pain; sacral pain; sciatica