An acetabular paralabral cyst is a benign soft tissue cyst usually seen in association with a tear of the acetabular labrum. Acetabular paralabral cysts are often the cause of joint pain, but they rarely cause compression of the adjacent neurovascular structures. We present a case of a 63-year-old male patient who had paresis and atrophy of right hip adductor muscles. Right obturator neuropathy was confirmed through an electrodiagnostic study. In addition, magnetic resonance imaging showed a paralabral cyst in the right acetabulum which extended to the pelvic wall. The patient underwent conservative treatment without surgical procedure. The pain was decreased after 1 month of conservative therapy. The pain was decreased at the 1-month follow-up. Follow-up electromyography showed polyphasic motor unit potentials in adductor magnus and adductor longus muscles. Based on the experience of this case, an acetabular paralabral cyst should be considered as one of the rare causes of obturator neuropathy.
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Method26 cerebral palsy children with spastic hip adductor muscles went under inhalation general anesthesia by anesthesiologist for phenol block of obturator nerve. After induction with thiopental sodium and sustained with sevoflurane by face mask without the use of muscle relaxant, the vital signs including heart rate, blood pressure and oxygen saturation were closely monitored throughout the procedure. The obturator nerve block was carried out with 5% phenol using a stimulator. Modified Ashworth scale (MAS) and range of motion of hip were measured before and after the procedure to compare the effects of nerve block.
ResultsNo significant differences were observed from the vital signs before, during and after the procedure. The MAS score improved from average 2.50±0.71 to 1.12±0.32. The range of motion increased from 24.31±12.32o and 25.88±12.28o right and left relatively to 39.62±10.10o and 40.96±11.14o.
ConclusionBoth spasticity and range of motion of hip adductor muscles improved significantly after obturator nerve block with 5% phenol under inhalation general anesthesia in the operating room with face mask, and no adverse effects or complications were seen in all 26 cerebral palsy children. Therefore phenol nerve block under inhalation general anesthesia in operation room for cerebral palsy children with poor cooperation or positioning difficulty due to spasticity should be considered as a useful method.
Objective: To get the mean values of obturator nerve conduction from 20 healthy adults.
Method: Magnetic stimulation of the stimulated paralumbar area of the 3 to 4 root levels with needle electrodes placed in adductor brevis muscle and adductor longus muscle for both sides for recording.
Results: The mean latency was 5.44±0.91 msec in the right adductor brevis muscle, 5.70±0.62 msec in the left adductor brevis muscle, 5.49±0.73 msec in the right adductor longus muscle and 5.61±0.70 msec in the left adductor longus muscle. There was no significant difference between adductor longus and adductor brevis muscles for the mean latency. The mean amplitude was 11.26±4.10 mV in right adductor brevis muscle and 11.65±4.20 mV in left adductor brevis muscle, and 11.14±3.58 mV in right adductor longus muscle and 11.01±3.18 mV in left adductor longus muscle. There was no significant difference between adductor longus and adductor brevis muscles for the mean amplitude.
Conclusion: Obturator nerve conduction study using magnetic stimulation can be a useful tool for the evaluation of obturator nerve injury.
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