Health Organization for Pudendal Education

Hello - my latest neurologist wants me to have a lumbar puncture as he suspects non-mechanical inflammation/infiltration of S1/S2/S3 nerve roots may be responsible for my symptons. I have had multipple MRI, including one with Doc Potter, that show no lesions or scarring in Lumbar or Pelvis. Also had multiple injections, including ischial spine/piriformis and Alcock and inferior cluneal nerve and a caudal epidural. Also one injection into the right hip. None of them worked either diagnostically or thereputically. My symptons started of with right sided bottock pain on sitting/then testicular tingling on sitting and then burning feet (not positional related). Latest nerve conduction study shows S1 nerve root conduction slowing down from a year ago. Wondering whether anybody has on any views on whether my symptons could come from S1/2/3 rather than pudendal nerve etc. I am scared about having a lumbar puncture as I have read about some nasty risks. All views appreciated.

Hi Question,
A lumbar puncture certainly does sound scary. I'm not familiar with the procedure - what does your neurologist hope to gain? To relieve pressure? Did he perform a test to confirm inflammation or is he guessing?

Question wrote:Wondering whether anybody has on any views on whether my symptons could come from S1/2/3 rather than pudendal nerve etc.

Well, your the PN originates from those sacral nerve roots.

Question wrote:and then burning feet (not positional related).

Depending on the area of burning; could be the sacral nerve roots as well. And/or the lower lumbar spine (L1 -L5).
This isn't my favorite dermatome map, but maybe you can match up some of your symptoms by viewing it:
http://www.backpain-guide.com/Chapter_F ... pathy.html

Wishing you the best, Question. Please keep us updated!
Warm regards,
Karyn

Question, if your S 2,3 nerve roots are irritated you can have the same symptoms that you would have with pudendal nerve entrapment because the pudendal nerve comes from S 2,3,4. I don't blame you for being a bit nervous about this diagnostic test. Would they be using image guidance?

Would an MRI of the sacrum be a good idea before checking for PNE? Would it show misalignment?

An MRI would be a good idea but it won't necessarily show a misalignment. You can ask them to check for tarlov cysts and you ask if they could use Dr. Hollis Potter's protocol to check for pudendal nerve entrapment.

Violet