坐骨神經痛合併腦腫瘤：病例報告

Sciatica Combined with Brain Tumor: Case Report

賀中權(Jong-Chyuan Heh) ； 曾堯人(Yau-Jen Tseng)

《中華民國復健醫學會雜誌》 19期 (1991/12) Pp. 147-153

摘要

造成坐骨神經痛的原因有很多，但絕大多數的病案起因於椎間盤脫出症，腰椎退行性病變或腸薦關節疾病。而頂葉腦腫瘤之臨床表徵以感覺和運動異常最常見。但椎間盤脫出症或腰椎退行性病變合併原發性頂葉腦腫瘤共同引起大腿和小腿感覺異常，運動無力者並不常見。本文報告二例因椎間盤脫出症和腰椎退行性病變而有坐骨神經痛症狀，接受復健治療壹週半後，其症狀未改善卻加重，因警覺有異故做進一步檢查而發現合併腦瘤的病例，以供臨床醫師參考，並建議醫師應常追蹤病人病況和理學檢查，若病程不如醫師所預期者，應提高警覺，並進一步考慮是否有其他因素影響，期能早期診斷和治療。

關鍵字

坐骨神經痛 ； 腦腫瘤

並列摘要

There are so many causes of sciatica, and most cases are due to lesions of the lumbar intervertebral disc. lumbar spondylosis or sacroiliac disease. Sensory and motor abnormalities are common in the parietal lobe brain tumor. The impairment of sensory and motor functions in leg and thigh due to the herniation of intervertebral disc or spondylosis combined with the parietal lobe brain tumor is rarely found. Of the two proposed cases, they all had the symptom of sciatica, and HIVD and spondylosis were diagnosed by a series of examinations including CT scan. Their symptoms and signs got no improvement after ten days' rehabilitative program, and, moreover, deteriorated. So we were alert to further evaluate patients, hence found parietal brain tumor. So authors suggest closely follow up and frequently check up patient's condition including physical examinations, especially when something deviate the expected disease course to make further correct diagnosis and treatment.