8520 - Sciatic nerve-Paralysis of

DBQ: Link to Index of DBQ/Exams by Disability for DC 8520 

Definition

Paralysis refers to a temporary or permanent loss of motor or sensory function in a part. This code refers to the sciatic nerve. The sciatic nerve, the largest nerve in the body, arises from the sacral plexus on either side, passing from the pelvis, down the back of the thigh, where it divides into the tibial nerve and peroneal nerve.

Etiology

Compression of the sciatic nerve or its roots may cause the paralysis. Causes of damage to the nerve may include: ruptured intervertebral disc (see Diagnostic Code: 5243 Intervertebral disc syndrome); osteoarthritis; tumor; inflammation of the sciatic nerve; trauma; gunshot and stab wounds; fractures of the pelvis or femur; or, accidentally, by intramuscular injections.

Signs & Symptoms

Signs and symptoms of sciatic disorders may include muscle weakness on the affected side of all movements of the ankle and toes. The paralyses include the following movements: knee flexion, hip abduction, ankle dorsiflexion and plantar flexion, and all toe movements. Some skin numbness and pain are present along the nerve distribution, and atrophy of the involved muscles.

Tests

Diagnostic measures would most likely include: lumbosacral, hip, pelvic and sacroiliac x-rays; cerebrospinal fluid (CSF) examination; computed tomography (CT) scan; magnetic resonance imaging (MRI); electromyography (EMG) studies; angiography; muscle-strength testing; and reflex testing.

Treatment

Essentially, treatment is aimed at the underlying cause. Therapy measures may include: use of braces, crutches, and a walker; physical therapy; analgesics; and electrical stimulation.

Residuals

Sciatic nerve paralysis outcomes will depend upon whether the condition is temporary or permanent.

Special Considerations

  • If the Veteran is a former prisoner of war and was interned or detained for not less than 30 days, this disease shall be service connected if manifest to a degree of disability of 10% or more at any time after discharge or release from active military, naval, or air service even though there is no record of such disease during service, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied [38 CFR §3.309(c) Disease subject to presumptive service connection].

  • If the Veteran was exposed to an herbicide agent during active military, naval, or air service, this disease shall be service-connected if the requirements of 38 CFR 3.307(a)(6) are met even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 CFR 3.309(e). Disease subject to presumptive service connection.

  • Consider potential entitlement to special monthly compensation for loss of use of hand or foot when assigning the higher evaluations under particular Diagnostic Codes (e.g., Diagnostic Code 8510 through 8515, 8520, and 8521)..

  • This disability shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied.  38 CFR 3.309(a)

Notes

  • Neuritis, cranial or peripheral, characterized by loss of reflexes, muscle atrophy, sensory disturbances, and constant pain, at times excruciating, is to be rated on the scale provided for injury of the nerve involved, with a maximum equal to severe, incomplete, paralysis. See nerve involved for diagnostic code number and rating. The maximum rating which may be assigned for neuritis not characterized by organic changes referred to in this section will be that for moderate, or with sciatic nerve involvement, for moderately severe, incomplete paralysis.  38 CFR 4.123 Neuritis, cranial or peripheral.

  • With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves] 38 CFR 4.124a Schedule of ratings—neurological conditions and convulsive disorders.