Skip to main content
Top
Published in: Pediatric Radiology 8/2012

01-08-2012 | Original Article

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

Authors: Adrien Roux, Catherine Tréguier, Bertrand Bruneau, Franck Marin, Laurent Riffaud, Philippe Violas, Anne Michel, Yves Gandon, Jean-Yves Gauvrit

Published in: Pediatric Radiology | Issue 8/2012

Login to get access

Abstract

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.
Literature
1.
go back to reference Imaginariojda G, Coelho B, Tome F et al (1964) Monosymptomatic interstitial hypertrophic neuritis. J Neurol Sci 64:340–347PubMedCrossRef Imaginariojda G, Coelho B, Tome F et al (1964) Monosymptomatic interstitial hypertrophic neuritis. J Neurol Sci 64:340–347PubMedCrossRef
2.
go back to reference Emory TS, Scheithauer BW, Hirose T et al (1995) Intraneural perineurioma. A clonal neoplasm associated with abnormalities of chromosome 22. Am J Clin Pathol 103:696–704PubMed Emory TS, Scheithauer BW, Hirose T et al (1995) Intraneural perineurioma. A clonal neoplasm associated with abnormalities of chromosome 22. Am J Clin Pathol 103:696–704PubMed
3.
go back to reference Bilbao JM, Khoury NJ, Hudson AR et al (1984) Perineurioma (localized hypertrophic neuropathy). Arch Pathol Lab Med 108:557–560PubMed Bilbao JM, Khoury NJ, Hudson AR et al (1984) Perineurioma (localized hypertrophic neuropathy). Arch Pathol Lab Med 108:557–560PubMed
4.
go back to reference Johnson PC, Kline DG (1989) Localized hypertrophic neuropathy: possible focal perineurial barrier defect. Acta Neuropathol 77:514–518PubMedCrossRef Johnson PC, Kline DG (1989) Localized hypertrophic neuropathy: possible focal perineurial barrier defect. Acta Neuropathol 77:514–518PubMedCrossRef
5.
go back to reference Stanton C, Perentes E, Phillips L et al (1988) The immunohistochemical demonstration of early perineurial change in the development of localized hypertrophic neuropathy. Hum Pathol 19:1455–1457PubMedCrossRef Stanton C, Perentes E, Phillips L et al (1988) The immunohistochemical demonstration of early perineurial change in the development of localized hypertrophic neuropathy. Hum Pathol 19:1455–1457PubMedCrossRef
6.
go back to reference Cazals-Hatem D, Kania R, Deroin P et al (2000) La neuropathie hypertrophique localisee: diagnostic differentiel du perineurome intra-neural. Ann Pathol 20:93–94PubMed Cazals-Hatem D, Kania R, Deroin P et al (2000) La neuropathie hypertrophique localisee: diagnostic differentiel du perineurome intra-neural. Ann Pathol 20:93–94PubMed
7.
go back to reference Hornick JL, Fletcher CD (2005) Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features. Am J Surg Pathol 29:845–858PubMedCrossRef Hornick JL, Fletcher CD (2005) Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features. Am J Surg Pathol 29:845–858PubMedCrossRef
8.
go back to reference Mitsumoto H, Wilbourn AJ, Goren H (1980) Perineurioma as the cause of localized hypertrophic neuropathy. Muscle Nerve 3:403–412PubMedCrossRef Mitsumoto H, Wilbourn AJ, Goren H (1980) Perineurioma as the cause of localized hypertrophic neuropathy. Muscle Nerve 3:403–412PubMedCrossRef
9.
go back to reference Gruen JP, Mitchell W, Kline DG (1998) Resection and graft repair for localized hypertrophic neuropathy. Neurosurgery 43:78–83PubMedCrossRef Gruen JP, Mitchell W, Kline DG (1998) Resection and graft repair for localized hypertrophic neuropathy. Neurosurgery 43:78–83PubMedCrossRef
10.
go back to reference Mauermann ML, Amrami KK, Kuntz NL et al (2009) Longitudinal study of intraneural perineurioma – a benign, focal hypertrophic neuropathy of youth. Brain 132:2265–2276PubMedCrossRef Mauermann ML, Amrami KK, Kuntz NL et al (2009) Longitudinal study of intraneural perineurioma – a benign, focal hypertrophic neuropathy of youth. Brain 132:2265–2276PubMedCrossRef
11.
go back to reference Takao M, Fukuuchi Y, Koto A et al (1999) Localized hypertrophic mononeuropathy involving the femoral nerve. Neurology 52:389–392PubMedCrossRef Takao M, Fukuuchi Y, Koto A et al (1999) Localized hypertrophic mononeuropathy involving the femoral nerve. Neurology 52:389–392PubMedCrossRef
12.
go back to reference Chou SM (1992) Immunohistochemical and ultrastructural classification of peripheral neuropathies with onion-bulbs. Clin Neuropathol 11:109–114PubMed Chou SM (1992) Immunohistochemical and ultrastructural classification of peripheral neuropathies with onion-bulbs. Clin Neuropathol 11:109–114PubMed
13.
go back to reference Simmons Z, Mahadeen ZI, Kothari MJ et al (1999) Localized hypertrophic neuropathy: magnetic resonance imaging findings and long-term follow-up. Muscle Nerve 22:28–36PubMedCrossRef Simmons Z, Mahadeen ZI, Kothari MJ et al (1999) Localized hypertrophic neuropathy: magnetic resonance imaging findings and long-term follow-up. Muscle Nerve 22:28–36PubMedCrossRef
14.
go back to reference Saguintaah M, Veyrac C, Baud C et al (2002) Neuropathie hypertrophique localisee (NHL) du plexus brachial: diagnostic et bilan preoperatoire par l’IRM. J Radiol 83:745–747PubMed Saguintaah M, Veyrac C, Baud C et al (2002) Neuropathie hypertrophique localisee (NHL) du plexus brachial: diagnostic et bilan preoperatoire par l’IRM. J Radiol 83:745–747PubMed
15.
go back to reference Kania RE, Cazals-Hatem D, Bouccara D et al (2001) Hypertrophic neuropathy of the facial nerve. Ann Otol Rhinol Laryngol 110:257–262PubMed Kania RE, Cazals-Hatem D, Bouccara D et al (2001) Hypertrophic neuropathy of the facial nerve. Ann Otol Rhinol Laryngol 110:257–262PubMed
16.
go back to reference Merlini L, Viallon M, De Coulon G et al (2008) MRI neurography and diffusion tensor imaging of a sciatic perineurioma in a child. Pediatr Radiol 38:1009–1012PubMedCrossRef Merlini L, Viallon M, De Coulon G et al (2008) MRI neurography and diffusion tensor imaging of a sciatic perineurioma in a child. Pediatr Radiol 38:1009–1012PubMedCrossRef
17.
18.
go back to reference Sciacco M, Scarpini E, Baron PL et al (1992) Sural nerve immunoreactivity for nerve growth factor receptor in a case of localized hypertrophic neuropathy. Acta Neuropathol 83:547–553PubMedCrossRef Sciacco M, Scarpini E, Baron PL et al (1992) Sural nerve immunoreactivity for nerve growth factor receptor in a case of localized hypertrophic neuropathy. Acta Neuropathol 83:547–553PubMedCrossRef
19.
go back to reference Suarez GA, Giannini C, Smith BE et al (1994) Localized hypertrophic neuropathy. Mayo Clin Proc 69:747–748PubMed Suarez GA, Giannini C, Smith BE et al (1994) Localized hypertrophic neuropathy. Mayo Clin Proc 69:747–748PubMed
20.
go back to reference Phillips LH 2nd, Persing JA, Vandenberg SR (1991) Electrophysiological findings in localized hypertrophic mononeuropathy. Muscle Nerve 14:335–341PubMedCrossRef Phillips LH 2nd, Persing JA, Vandenberg SR (1991) Electrophysiological findings in localized hypertrophic mononeuropathy. Muscle Nerve 14:335–341PubMedCrossRef
21.
go back to reference Chhabra A, Subhawong TK, Bizzell C et al (2011) 3 T MR neurography using three-dimensional diffusion-weighted PSIF: technical issues and advantages. Skeletal Radiol 40:1355–1360PubMedCrossRef Chhabra A, Subhawong TK, Bizzell C et al (2011) 3 T MR neurography using three-dimensional diffusion-weighted PSIF: technical issues and advantages. Skeletal Radiol 40:1355–1360PubMedCrossRef
22.
go back to reference Yassini PR, Sauter K, Schochet SS et al (1993) Localized hypertrophic mononeuropathy involving spinal roots and associated with sacral meningocele. Case report. J Neurosurg 79:774–778PubMedCrossRef Yassini PR, Sauter K, Schochet SS et al (1993) Localized hypertrophic mononeuropathy involving spinal roots and associated with sacral meningocele. Case report. J Neurosurg 79:774–778PubMedCrossRef
23.
go back to reference Smith AB, Gupta N, Strober J et al (2008) Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol 38:159–163PubMedCrossRef Smith AB, Gupta N, Strober J et al (2008) Magnetic resonance neurography in children with birth-related brachial plexus injury. Pediatr Radiol 38:159–163PubMedCrossRef
24.
go back to reference Ma M, Guillerman RP (2010) Paradoxic hypertrophy of the sciatic nerve. Pediatr Radiol 40(Suppl 1):S177PubMedCrossRef Ma M, Guillerman RP (2010) Paradoxic hypertrophy of the sciatic nerve. Pediatr Radiol 40(Suppl 1):S177PubMedCrossRef
Metadata
Title
Localized hypertrophic neuropathy of the sciatic nerve in children: MRI findings
Authors
Adrien Roux
Catherine Tréguier
Bertrand Bruneau
Franck Marin
Laurent Riffaud
Philippe Violas
Anne Michel
Yves Gandon
Jean-Yves Gauvrit
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 8/2012
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-012-2418-y

Other articles of this Issue 8/2012

Pediatric Radiology 8/2012 Go to the issue

Hermes

Hermes