Lumbosciatalgia Due to Pyramidal Syndrome
Bibliographic record
Abstract
Piriformis syndrome is a poorly known cause of sciatica and there are few cases reported in the international literature where sciatica is the form of presentation. It is caused by compression or entrapment of the sciatic nerve due to piriformis muscle pathology. A 65-year-old Caucasian man was admitted in Department of Neurology because he suffered from sciatica and weakness of the left lower limb, so initially a disc herniation was suspected. Upon physical examination, he presented marked gluteal muscle atrophy, mild quadriceps muscle atrophy and paresis of the left lower extremity with distal dominance. Electroneuromyography provided evidence of left sciatic nerve injury of severe intensity and profuse signs of active denervation present. MRI lumbar plexus revealed asymmetrical enlargement of the left piriformis muscle that obliterated the ipsilateral greater sciatic foramen, compressing the left sciatic nerve. As a result, secondary atrophy of the gluteus maximus and medius can be observed on this side. Due to the severity of the symptoms, surgery was performed to release the nerve. Piriformis syndrome rarely occurs as sciatica. The diagnosis is usually delayed because of the absence of further pathognomic testing and established diagnostic criteria, which are based on clinical manifestations. This syndrome is often confused with lumbar-sacral or hip disease. So, in a disease such as the case presented, the piriformis syndrome should be considered. We think that it is very interesting to know that a piriformis syndrome can debut as a lumbosciatalgia and it can be confused with lumbar disc pathology, so this may delay the diagnosis and cause further suffering to the patient. J Med Cases. 2016;7(6):248-251 doi: http://dx.doi.org/10.14740/jmc2503w
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".