Post-Injection Sciatic Nerve Palsy in a patient with PIVD
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Prolapsed intervertebral disc (PIVD) commonly presents as lower back ache associated with features of radiculopathy. We present an unusual case of a patient presenting with foot drop and our diagnostic and therapeutic protocol for the same. Our patient was a 40 year old female who was diagnosed as a case of PIVD L4-L5 and was advised for non operative treatment. During her treatment, the patient received intramuscular analgesic therapy immediately following which the patient reported a foot drop in the le lower limb. While the patient was initially thought to present with an acute neurological worsening of the affected disk requiring urgent decompression. However post injection nerve palsy was kept as one of the differential. e diagnosis of post injection palsy was conrmed by obtaining an NCV study and MRI neurography. She was subsequently managed conservatively via a foot drop splint, oral analgesic therapy and neurotropic agents. On follow up at 6 months she had complete neurological recovery. Post injection palsy can mimic as further prolapse of disc in a case of PIVD. It is imperative to differentiate these two as the management follows different course, the differentiation can be done using MR neurography.
Authors and Affiliations
Deepankar Verma, Anil K Jain, Anuragini Gupta, Himanshu Bhayana
Keywords
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