Sciatic nerve palsy complicating umbilical arterial catheterization

Fok, T. F.; Ha, Mina; Leung, Aaron Kam-Lun; Wong, W. K.

doi:10.1007/bf00439407

Cited by 9 publications

(2 citation statements)

References 3 publications

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“…There are rare reports of sciatic and peroneal neuropathies following umbilical artery catheterization. 30 Two of our children, a 4-year-old with an arteriovenous malformation (AVM) of the right lower extremity and a 10-year-old with iliac artery stenosis and AVM, developed SN following embolization procedures; this is an infrequent complication of embolization. 31 One 3-year-old boy with disseminated intravascular coagulation due to meningococcemia developed SN in one limb and an ischemic contralateral lower limb that required amputation; this is an unusual complication of meningococcemia.…”

Section: Prolonged Compression or Immobilization (6)mentioning

confidence: 93%

Pediatric sciatic neuropathies

Srinivasan¹,

Ryan

Escolar³

et al. 2011

Neurology

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Objective: The incidence, cause, and prognosis of sciatic neuropathy in children is not well understood. We report our 30-year experience of 53 patients with pediatric sciatic neuropathies (SN).Methods: Prospective review of the history, physical examination, electrophysiologic findings, and clinical course of children with SN. Results:The etiology of SN injury was varied and included trauma (13), iatrogenic causes (13) (8 orthopedic surgeries and 5 miscellaneous surgeries), prolonged extrinsic compression and immobilization (6), tumors (7), vascular (5), idiopathic and progressive (4), infantile and nonprogressive (2), and unknown, presumed postviral (3). Electrophysiologic studies demonstrated abnormalities in motor conduction studies of the peroneal nerve in 44/53 (83%) or tibial nerve in 35/51 (67%). Sensory conduction studies were abnormal in sural nerve in 34 of 43 cases (79%), and superficial peroneal nerves in 15/25 (60%). Needle EMG was abnormal in peroneal innervated muscles in all subjects, in tibial nerve innervated muscles in 43/51 (84%), and in the hamstrings in 18/29 (62%). Prognosis for recovery was variable and depended on the etiology and the severity of the nerve injury. Mononeuropathies are uncommon in children; however, in our experience, pediatric sciatic neuropathy (SN) represents approximately one-fourth of all mononeuropathies. Conclusions:1 SN lesions may be underappreciated in childhood. We describe the clinical features of children who presented with SN over a 30-year period. Clinical assessment. Staff neurologists, neurosurgeons, or orthopedic surgeons evaluated all children in the study before EMG evaluation. A staff electromyographer reviewed the history and neurologic examination at the time of the EMG with the patient and parents/ guardians. Follow-up data were obtained by clinical examination, review of charts, telephone conversations, and occasionally a repeat EMG. Electrophysiologic evaluation.Nerve conduction studies (NCS) and needle EMG were performed in children using Dantec Counterpoint (Dantec Electronic, Tonsbakken, Skovlunde, Denmark), TECS TE42 machine (Teca Corporation, Pleasantville, NY) or the Teca TM Synergy N-EM-EMG monitoring systems (Oxford Instruments, Oxford, UK); standard filter settings were utilized. Electrophysiologic studies were performed without sedation in the majority; in rare instances, sedation was used. In each child with a suspected SN, motor NCS included responses from the extensor digitorum brevis, abductor hallucis brevis, and in some instances tibialis anterior. Sensory NCS included sural nerve and in some instances superficial peroneal nerve responses. Plantar sensory responses were studied in preference to the technically difficult sural response in infants. Contralateral limbs were studied if there was possibility of a systemic process or multiple limb involvement. Normative data were as previously published. 1 H-reflex studies and F-wave studies were performed infrequently. Muscles

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Section: Prolonged Compression or Immobilization (6)mentioning

confidence: 93%

Pediatric sciatic neuropathies

Srinivasan¹,

Ryan

Escolar³

et al. 2011

Neurology

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“…There are rare reports of sciatic and peroneal neuropathies after umbilical artery catheterization. 5,6 Another child had iliac artery stenosis and an arteriovenous malformation, and a pediatric sciatic neuropathy developed after an embolization procedure. The likely pathogenesis of pediatric sciatic neuropathy in these 2 patients was thromboembolism of the inferior gluteal artery and ischemia of the sciatic nerve (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Sciatic Neuropathies Due to Unusual Vascular Causes

et al. 2008

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Four cases of pediatric sciatic neuropathies due to unusual vascular mechanisms are reported. Pediatric sciatic neuropathies were seen after umbilical artery catheterization, embolization of arteriovenous malformation, meningococcemia, and hypereosinophilic vasculitis. Electrophysiologic studies demonstrated abnormalities in motor studies of peroneal and tibial nerves. Sensory studies demonstrated abnormalities of sural and superficial peroneal nerves. Results of needle electromyography were abnormal in sciatic-innervated muscles. Prognosis was variable and depended on the severity of the initial nerve injury.

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Iatrogenic Disease

Howatson¹

2001

Fetal and Neonatal Pathology

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Sciatic nerve palsy complicating umbilical arterial catheterization

Cited by 9 publications

References 3 publications

Pediatric sciatic neuropathies

Pediatric sciatic neuropathies

Pediatric Sciatic Neuropathies Due to Unusual Vascular Causes

Iatrogenic Disease

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