Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve. Case report

John R. Floyd, Elizabeth R. Keeler, Elizabeth D. Euscher, Ian E. Mccutcheon

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Sciatic (catamenial) radiculopathy, waxing and waning with the menstrual cycle, is an uncommon condition typically caused by pelvic endometriosis affecting the lumbosacral plexus or proximal sciatic nerve. The authors describe a woman with catamenial sciatica caused by endometriosis affecting the sciatic nerve trunk in the upper thigh. Symptomatic with leg pain for 5 years, this patient developed gluteal atrophy and sensory loss and decreased strength in the L-5 dermatomyotome, a distribution confirmed by electromyography. Magnetic resonance imaging suggested thickening of the sciatic nerve at and distal to the sciatic notch. At operation the nerve showed extrinsic and intrinsic abnormality, proven to be endometriosis. Her symptoms improved, and she began gonadotropin-releasing hormone agonist therapy for further suppression. This very unusual case shows that endometriosis can affect the sciatic nerve over a range of territory inside and outside the pelvis, and that surgery must be appropriately directed to avoid negative exploration. Surgical decompression achieves good relief of symptoms, and medical therapy also allows sustained suppression of this disease.

Original languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalJournal of Neurosurgery: Spine
Issue number2
StatePublished - Feb 2011


  • Catamenial
  • Endometriosis
  • Sciatic nerve
  • Sciatic notch

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Surgery


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