Perineurioma of the sciatic nerve: a possible cause of idiopathic foot drop in children: report of 4 cases

J Neurosurg Pediatr. 2010 Nov;6(5):506-10. doi: 10.3171/2010.8.PEDS10214.

Abstract

The authors report on a loss of foot dorsiflexion in pediatric-age individuals and suggest that the possible cause could be a perineurioma of the sciatic nerve. The authors describe 4 cases in which foot drop in the absence of sensory discomfort was the heralding sign of perineurioma of the sciatic nerve. Magnetic resonance imaging showed a focal enlargement of the sciatic nerve, but the tumor was confined only to its lateral compartment. Treatment in 2 cases involved excision of the affected segment and subsequent graft repair. The two other patients shared the same clinical, radiological, and surgical findings, but no nerve biopsy sample was obtained; the patients underwent only a tibialis posterior muscle transfer. Long-term recovery of nerve function never occurred. Because tumor resection and nerve graft yield no functional results, a tendon transfer to restore walking may be the sole useful surgical procedure in these cases. Removal of the tumor may not be necessary because long-term follow-up confirms that perineuriomas are self-limiting and the final prognosis is favorable.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Electromyography
  • Female
  • Follow-Up Studies
  • Gait Disorders, Neurologic / diagnosis
  • Gait Disorders, Neurologic / etiology*
  • Gait Disorders, Neurologic / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Nerve Sheath Neoplasms / complications*
  • Nerve Sheath Neoplasms / diagnosis
  • Nerve Sheath Neoplasms / pathology
  • Nerve Sheath Neoplasms / surgery
  • Nerve Transfer / methods
  • Peripheral Nervous System Neoplasms / complications*
  • Peripheral Nervous System Neoplasms / diagnosis
  • Peripheral Nervous System Neoplasms / pathology
  • Peripheral Nervous System Neoplasms / surgery
  • Peroneal Neuropathies / diagnosis
  • Peroneal Neuropathies / etiology*
  • Peroneal Neuropathies / surgery
  • Prognosis
  • Sciatic Neuropathy / complications*
  • Sciatic Neuropathy / diagnosis
  • Sciatic Neuropathy / pathology
  • Sciatic Neuropathy / surgery
  • Tendon Transfer / methods
  • Ultrasonography