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Electromyographic Abnormalities Associated with Symptomatic Sacral Tarlov Cysts
Author(s) -
Hulens Mieke,
Bruyninckx Frans,
Dankaerts Wim,
Vansant Greet,
De Mulder Peter A.
Publication year - 2016
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12441
Subject(s) - medicine , electromyography , asymptomatic , pathological , sacrum , lumbar , surgery , lumbosacral plexus , nerve root , neuropathic pain , genitourinary system , low back pain , radiology , anatomy , physical medicine and rehabilitation , pathology , anesthesia , alternative medicine
Tarlov or perineural cysts ( TC ) are commonly overlooked as a cause of sacral and ischial pain, and urogenital and bowel problems. TC can be seen on MRI , but are often considered asymptomatic. This is especially true for smaller cysts. Moreover, there are only few diagnostic characteristics that can be used to confirm that the cysts are the cause of the symptoms. As a consequence, a lot of controversy remains regarding the clinical importance of TC . Because of this underdiagnosed condition, patients often suffer for several years from unrecognized chronic neuropathic pain and neurological conditions. In this article, case reports of three patients with giant and smaller symptomatic sacral cysts are presented, in which electromyographic testing was performed to demonstrate nerve damage. We suggest that electromyography of the sacral nerve roots can be a reasonable tool for the diagnosis of symptomatic TC , as well as for the differentiation from other pathological entities causing sacral and ischial pain. Moreover, using electromyography it was also documented that smaller cysts of < 1 cm can cause nerve damage. Therefore incidence of symptomatic TC may be higher than initially thought.