Severe isolated sciatic neuropathy due to a modified lotus position

Abstract

A 51-year-old man presented to our hospital with progressive pain and weakness in his right leg. Neurological examination revealed atrophy of all muscles of the right leg, unilateral foot drop and paralysis of the anterior tibial and gastrocnemicus muscles. Electromyography confirmed a severe isolated sciatic neuropathy in the thigh. For unclear reasons, our patient habitually used to sit in a modified lotus position. We concluded that this position, in literature known as “lotus neuropathy” had resulted in the sciatic neuropathy. After more than a year our patient was referred again to our outpatient clinic. At that time there was only minimal improvement, now with an achilles tendon contracture and pes equinus due to immobility.

Keywords: Sciatic neuropathy; Lotus neuropathy; Sciatic nerve

Core tip: In this case history we report on a patient with a severe isolated sciatic neuropathy with a foot drop, a complication of prolonged sitting in a modified lotus position. Although rare, similar reports of sciatic nerve injury due to external compression as a result of prolonged or repeated sitting in the same position have been reported. A so-called “lotus neuropathy” should be included in the differential diagnosis in patients presenting with a isolated sciatic neuropathy.