Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings

Background Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. Objective To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Materi...

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Bibliographic Details
Published in:Pediatric radiology 2012-08, Vol.42 (8), p.952-958
Main Authors: Roux, Adrien, Tréguier, Catherine, Bruneau, Bertrand, Marin, Franck, Riffaud, Laurent, Violas, Philippe, Michel, Anne, Gandon, Yves, Gauvrit, Jean-Yves
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carotid Stenosis
Child
Child, Preschool
Contrast Media
Electromyography
Female
Hemorrhage
Humans
Hypertrophy
Imaging
Imaging, Three-Dimensional
Infant
Leg
Leg - innervation
Life Sciences
Magnetic Resonance Imaging
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Multivariate Analysis
Neurons and Cognition
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Pediatrics
Peripheral Nervous System Diseases
Peripheral Nervous System Diseases - diagnosis
Peripheral Nervous System Diseases - pathology
Predictive Value of Tests
Prospective Studies
Radiology
Retrospective Studies
Risk Factors
Sciatic Nerve
Sciatic Nerve - pathology
Stroke
Ultrasound
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Summary:Background Localized hypertrophic neuropathy (LHN) of the sciatic nerve in children is a rare condition characterized by a painless neurological deficit in the sciatic nerve territory. Objective To demonstrate the role of MRI using a specific protocol and describe the primary findings in LHN. Materials and methods Imaging in four children (age 2 years to 12 years) is presented. All children presented with lower limb asymmetry. Three had a steppage gait. LHN was confirmed by electrophysiological studies and by MRI of the whole sciatic nerve with a dedicated protocol covering the lumbar spine and the lower limb. Results There were four direct MRI findings: (1) linear and focal hypertrophy with progressive enlargement of a peripheral nerve or plexus diameter, (2) abnormal hyperintensity of the nerve on T2-weighted images, (3) preserved fascicular configuration, and (4) variable enhancement after intravenous gadolinium administration. In addition there were atrophy and fatty infiltration of innervated muscles. MRI was helpful for determining the extent of lesions and in excluding peripheral nerve compression or tumour. Conclusion MRI of the whole sciatic nerve is the method of choice for diagnosing LHN of the sciatic nerve.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-012-2418-y