Etiopathogenesis, Clinical Features, Investigations, and Management of Peripheral Nerve Injuries

Sciatic Nerve Palsy: Causes, Clinical Presentation, Investigations, and Treatment

The sciatic nerve, the largest nerve in the human body, is essential for motor and sensory function in the lower limb. Sciatic nerve palsy, a debilitating condition, occurs due to various etiologies affecting its normal function.

Etiopathogenesis

Sciatic nerve injury can result from multiple causes, including traumatic events, surgical complications, or compression syndromes. Common etiologies include:

• Pelvic fractures
• Hip dislocations
• Iatrogenic injuries following surgery
• Prolonged compression due to improper posture
• Diabetic neuropathy

Clinical Features

Patients with sciatic nerve palsy present with characteristic symptoms affecting motor and sensory function:

• Paresthesia and numbness along the sciatic nerve distribution
• Weakness in knee flexion and foot dorsiflexion
• Loss of Achilles tendon reflex
• Gait disturbances due to foot drop

Investigations

Diagnostic evaluation is crucial to determine the extent of nerve damage and guide treatment. Investigations include:

• Electromyography (EMG) and nerve conduction studies
• Magnetic resonance imaging (MRI) for structural assessment
• Ultrasound for nerve visualization
• Blood tests for underlying metabolic disorders

Management

Treatment approaches vary based on the underlying cause and severity of injury:

• Physical therapy and rehabilitation for motor recovery
• Orthotic devices to support foot drop
• Medications for neuropathic pain (e.g., gabapentin, pregabalin)
• Surgical intervention in cases of severe nerve compression or trauma

Conclusion

Early diagnosis and management of sciatic nerve palsy are crucial to prevent long-term disability. A multidisciplinary approach involving neurologists, orthopedic surgeons, and physiotherapists ensures optimal patient outcomes.