Catamenial mononeuropathy and radiculopathy: a treatable neuropathic disorder

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  • 1 Departments of Neurosurgery, Obstetrics and Gynecology, Neurology, Surgery, and Radiology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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Object. The aim of this study was to investigate the indications and treatment options in patients with lower-extremity neuropathies and radiculopathies caused by endometriosis.

Methods. The authors identified five patients whose symptoms included catamenial pain, weakness, and sensory loss involving the sciatic and femoral nerves and multiple lumbosacral nerve roots. Radiographic studies supported the diagnosis of catamenial neuropathy or radiculopathy, but definitive diagnosis depended on surgical and pathological examination. Treatment of symptoms, including physical therapy and a course of antiinflammatory or analgesic medication, was not helpful. Patients responded favorably to hormonal therapy. Laparoscopy or open exploration for extrapelvic lesions was performed for diagnosis or for treatment when hormone therapy failed. Pain and sensory symptoms responded well to therapy. Weakness improved, but never recovered completely.

Conclusions. Catamenial neuropathy or radiculopathy should be considered when evaluating reproductive-age women with recurring focal neuropathic leg pain, weakness, and sensory loss.

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Contributor Notes

Address reprint requests to: Eric L. Zager, M.D., The Neurological Institute, University of Pennsylvania Medical Center, Silverstein Pavilion, 5th Floor, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.
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