발표연제 검색
- 연제번호 : P 2-136 북마크
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제목 Sciatic neuropathy after normal vaginal delivery: A case report 소속 Seoul National University Hospital, Department of Rehabilitation Medicine1, SMG-SNU Boramae Medical Center, Department of Rehabilitation Medicine2 저자 Se Hoon Kim1*, In Hee Kim1, Sang Yoon Lee2† Objective: Postpartum neuropathies of the lower extremity are possible complications after delivery and the incidence estimated at 1%. There have been a few case reports about sciatic neuropathy after caesarean section. However, a sciatic neuropathy after normal vaginal delivery has not been reported to date.
Methods: A 30-year-old woman visited our department with a chief complaint of left lower extremity weakness after normal vaginal delivery (at gestational age of 38+5 weeks) one month ago. The delivery took place under spinal anesthesia for about 6 hours. There was no dystocia and perinatal problems. She was primiparous and had medical history of gestational diabetes. Physical examination revealed a lower extremity weakness (MRC grade III of left ankle plantar flexor and a paresthesia at left posterior calf and sole. Magnetic resonance imaging (Figure 1), nerve conduction studies (Table 1), and electromyography (Table 2) were conducted. Finally, the patient was diagnosed as a left sciatic neuropathy at proximal to the branch to the biceps femoris.
Results: Her motor weakness and paresthesia were almost completely resolved spontaneously after 3 months. In addition, follow-up nerve conduction studies and electromyography showed nearly complete recovery state of left sciatic neuropathy (Table 1 and 2).
Conclusion: Sciatic neuropathy can occur after normal vaginal delivery even without dystocia and perinatal problems, which showed good prognosis.File.1: Table 1.GIFTable1. Results of sensory and motor nerve conduction studyFile.2: Table 2.GIFTable 2. Results of needle electromyography, H reflex, and F wave. Abbreviations; Fib, fibrillation; PSW, positive sharp waves; MUAP, motor unit action potential; Interf P, interference pattern; R/C, reduced to complete.File.3: Fig 1.GIFFig 1. T2-weighted Pelvis MRI. Diffuse swelling and increased T2 signal intensity of left sciatic nerve after left sciatic foramen marked by yellow arrowheads in transverse (A) and coronal view (B). These findings are consistent with left sciatic neuropathy.