Usefulness of Magnetic Resonance Neurography for Diagnosis of Piriformis Muscle Syndrome and Verification of the Effect After Botulinum Toxin Type A Injection: Two Cases.

Abstract

Piriformis muscle syndrome (PMS) is a controversial neuromuscular disorder that is presumed to involve compression neuropathy of the sciatic nerve at the level of the piriformis muscle. Botulinum toxin A (BTX-A) injection into the piriformis muscle is widely used as a treatment aimed at relieving sciatic nerve compression. In 2 patients with PMS, magnetic resonance neurography (MRN) was taken before and after BTX-A injection. The first MRN was performed as a diagnostic tool, and the second to identify the effect of the treatment. Signal change of the sciatic nerve under the hypertrophied piriformis muscle was confirmed by MRN. In follow-up MRN performed after BTX-A injection into the piriformis muscle, changes of the sciatic nerve and piriformis muscle were noticed as well as improvement of clinical symptoms. MRN is a useful tool to add certainty of diagnosis and verify the effect of treatment in PMS.

• Authors: Hea Eun Yang, Jung Hyun Park, Sungjun Kim
• Journal: Medicine (Medicine (Baltimore)) Vol. 94 Issue 38 Pg. e1504 (Sep 2015) ISSN: 1536-5964 [Electronic] United States
• PMID: 26402805 (Publication Type: Case Reports, Journal Article)

Chemical References

• Botulinum Toxins, Type A

Topics

• Botulinum Toxins, Type A (administration & dosage)
• Diagnostic Techniques, Neurological
• Humans
• Injections, Intramuscular
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Piriformis Muscle Syndrome (diagnosis, therapy)
• Radiography
• Sciatic Nerve (diagnostic imaging)
• Treatment Outcome