Presentation
Presents a consistent chapter organization that delivers all the content you need in a logical, practical manner. Presents a new co-editor, Thomas D. [books.google.com]
Asymmetric lumbosacral radiculoplexopathy: Rare presentation of sarcoidosis. Neurol India 2015;63:615-6 How to cite this URL: Ghuman MS, Kapur S, Vyas S, Bhatkar S, Goyal MK, Khandelwal N. [neurologyindia.com]
The condition can be the first presentation of diabetes. [patient.info]
In contrast to these monophasic presentations, other patients may present with a progressive course. [painspa.co.uk]
The clinical presentation and initial management of lumbosacral radiculopathies of various etiologies are discussed. [neurospine.wordpress.com]
Entire Body System
- Weight Loss
Weight loss is also common in this population. [now.aapmr.org]
Sensory impairment may be present but is minimal and occurs in the cutaneous distribution sharing the affected nerve root or peripheral nerve. [ 8 ] Weight loss occurs in more than half of patients. Stepwise progression occurs over months. [patient.info]
Diabetic amyotrophy Diabetic lumbosacral radiculoplexus neuropathy is a subacute, painful asymmetric lower limb neuropathy that is associated with significant weight loss (at least 10 pounds), type 2 diabetes mellitus, and relatively recent diagnosis [painspa.co.uk]
Important risk factors for serious underlying disease that should be sought in the history include age greater than 50, previous history of cancer, unexplained weight loss, and failure to improve after 1 month of conservative therapy. Box 1. [neurospine.wordpress.com]
Sensory loss is generally less pronounced,although patellar reflexes typically are absent or sluggish. Withprogression, noticeable muscle wasting occurs, resulting in significantatrophy and weight loss. [slideshare.net]
Skin
- Anhidrosis
This is most often secondary to anhidrosis in the limbs and thorax and reflects compensatory hyperhidrosis in the restricted areas that maintain normal sweating. [clevelandclinicmeded.com]
Musculoskeletal
- Leg Weakness
weakness Sensory Pain: Variable; Occasionally severe; More common with diabetes Loss: Distal; Often asymmetric Weakness Asymmetric Multifocal: Proximal, Distal or Both Bilateral: 2nd side onset mean 3 months after initial weakness Legs Disability: Usual [neuromuscular.wustl.edu]
A clinical examination revealed weakness of the right leg posterior compartment muscles but no palpable leg mass. [ajnr.org]
Sudden onset, unilateral lower extremity pain variably involves the groin, anterior thigh, and lower leg; weakness follows shortly. [neurospine.wordpress.com]
The subacute development of hip and leg pain that progresses over several weeks precedes proximal leg weakness, which may be severe. [neupsykey.com]
Most frequent clinical presentation of adiabetic lumbosacral plexopathy is anterior thigh pain, with secondaryproximal leg muscle weakness. The muscle weakness is most pronouncedin the quadriceps muscles. [slideshare.net]
- Thigh Pain
pain En bloc excision with right S1-S4 laminectomy Chin and Kim [9] 1 54 years/F Left anterior surface of the sacral ala Left sacral ala - Low back ache with left lower limb radiculopathy, neurological deficit En bloc excision through a retroperitoneal [cureus.com]
Sensation was diminished, touch and pain, over the anterior thigh and medial leg. [accessphysiotherapy.mhmedical.com]
Most frequent clinical presentation of adiabetic lumbosacral plexopathy is anterior thigh pain, with secondaryproximal leg muscle weakness. The muscle weakness is most pronouncedin the quadriceps muscles. [slideshare.net]
The test is positive if the patient experiences anterior thigh pain. [physio-pedia.com]
- Low Back Pain
In the literature you can find a lot of exercises for people with low back pain. [physio-pedia.com]
Polyradiculopathy in AIDS tends to involve the lumbosacral nerve roots, producing a rapidly progressive cauda equina syndrome with severe low back pain. Cytomegalovirus accounts for most HIV-related radiculopathy. [neurospine.wordpress.com]
An important study in the fascial world by Langevin et al., 2009 proposed that people with chronic and recurrent low back pain had 25 percent greater fascial thickness than a low back pain-free group. [treningogrehab.no]
- Myalgia
Muscle Muscle disorders produce wasting and weakness without sensory abnormalities, although cramps and myalgias may occur. [neupsykey.com]
More vs other NA Bilateral involvement (80%) Muscles involved: Supraspinatus; Infraspinatus; Deltoid; Triceps; Plexus trunks Damage outside brachial plexus (58%): Phrenic nerve (25%; Lumbosacral plexus (26%) Tendon reflexesL Reduced Sensory symptoms: Myalgia [neuromuscular.wustl.edu]
Urogenital
- Pelvic Pain
Since SNM has shown a favorable response for these approved indications, other therapeutic applications have been proposed for various conditions such as painful bladder syndrome, chronic pelvic pain and neurological voiding dysfunction in both adult [ncbi.nlm.nih.gov]
Fig. 23 It may also be compressed by the pelvic floor, but personally I have not found the pelvic floor to be a significant player in this dysfunction. [treningogrehab.no]
Neurologic
- Foot Drop
foot drop, because it supplies all of the foot and toe extensors; the patient cannot dorsiflex the foot and the toes will drag when the patient walks; there is sensory loss in the lateral aspect of the lower half of the leg and foot; painless foot drop [medschool.lsuhsc.edu]
Fingers bent in the proximal phalanges ("Foot drop", "clubbed foot", pes equinovarus). Characteristic steppage gait. Patient lying on his back, is asked to extend the ankle, adduct and lift the inner edge of the foot. [pain-clinic.ru]
drop, numbness Right partial hemilaminectomy at the L5-S1 level Sciubba et al [3] 5 - S1 (4 patients) L5-S3 (1 patient) - 4 cm3, 120 cm3, 120 cm3, 27 cm3 616 cm3 - En bloc excision, one recurrence Baruah et al. [10] 1 21 years/M Conjoint lamina of S3 [cureus.com]
The patient's condition failed to improve with conservative management, and she subsequently developed an additional left foot drop. [ajnr.org]
Lumbosacral trunk and upper sacral plexus lesions: foot drop (flail foot), and weakness of knee flexion or hip abduction. [epomedicine.com]
- Sciatica
This pain pattern is referred to as sciatica. Rarely, other conditions may cause pain radiating in the sciatic distribution, but the most common cause is radiculopathy. Anyone can get sciatica. [neurologylakemary.com]
Also the value of bed rest was examined in patients with sciatica; results suggest that advice for bed rest is not as effective as advice to stay active for people with low-back pain. [8]. [physio-pedia.com]
[…] superioris, non specificata G57 Mononeuropathies of lower limb Latin: Mononeuropathia extremitatis inferioris Excludes: current traumatic nerve disorder - see nerve injury by body region G57.0 Lesion of sciatic nerve Latin: Laesio nervi ischiadici Excludes: sciatica [mkb-dijagnoza.blogspot.com]
Compressive Neuropathy A 20-year-old male bodybuilder, said to have prominent development of his buttock musculature, presented with intractable left sciatica and loss of lower extremity muscle mass. Palpation over the left buttock exacerbated pain. [ajnr.org]
Patients may report of sciatica without back pain. Aggravation of pain with movement, particularly forward or lateral bending, or with Valsalva’s maneuver is typical; usually, pain is relieved with recumbency. [neurospine.wordpress.com]
- Limb Weakness
Acute or subacute onset of pain and lower motor neuron weakness involving predominantly the proximal muscles of the lower limbs. Weakness that is not confined to one nerve or nerve root distribution. [cochranelibrary.com]
Limb-girdle muscular dystrophy This is a heterogeneous group of conditions that usually appear in adolescence or adult life with proximal limb weakness. The weakness usually progresses slowly, but it may arrest spontaneously. [dartmouth.edu]
- Flaccid Paralysis
paralysis associated with sensory deficits to all types of stimulation in the territory of the damaged nerve roots: a lower motor neuron paralysis. [medlink.com]
- Dizziness
Pregabalin 150-300 mg Sedation, dizziness Carbamazepine 200-1200 mg Sedation, dizziness, nausea, bone marrow suppression Oxycarbazepine 600-2400 mg Fatigue, nausea, dizziness, leukopenia Lamotrigine 50-500 mg Serious rash, dizziness, nausea, sedation [clevelandclinicmeded.com]
Workup
Please see Table 2 for the diagnostic workup for lumbosacral plexopathy. [now.aapmr.org]
Other ECG Findings
- Ischemic Changes
[…] in myelinated fibres typical of ischemic changes (Dyck 2000a). [cochranelibrary.com]
Symptoms often resolve after evacuation of the hematoma if ischemic changes have yet to occur. [now.aapmr.org]
Treatment
Offers practical, clinically relevant material for the diagnosis and treatment of musculoskeletal conditions. [books.google.com]
Non-somatic Treatment Psychological Treatment Depression Treatment Cognitive-Behavioural Treatment Rehabilitation Treatment Somatic Treatment Pharmacological treatment: Non-steroid Anti-inflammatories (short period) Tricyclic antidepressants Anticonvulsives [pijn.com]
[…] scp=77953539169&partnerID=8YFLogxK U2 - 10.1007/s11940-010-0059-8 DO - 10.1007/s11940-010-0059-8 M3 - Article VL - 12 SP - 95 EP - 99 JO - Current Treatment Options in Neurology T2 - Current Treatment Options in Neurology JF - Current Treatment Options [mayoclinic.pure.elsevier.com]
Types of interventions Treatment with IVIg, corticosteroids, PE or any other form of immunotherapy for ILSP compared with no treatment, placebo, or other treatment. [cochranelibrary.com]
Radiation therapy is the mainstay of treatment of neoplastic infiltration; the treatment for radiation-related plexopathy is mainly supportive. [neupsykey.com]
Prognosis
[…] syndromes Upper plexus Lower plexus Retroclavicular Anatomy: Divisions Usually associated with upper or lower plexus lesions Isolated lesions: Uncommon Infraclavicular Anatomy: Cords & Terminal nerves No regional differences in incidence, severity, prognosis [neuromuscular.wustl.edu]
They have included background information about the historical notes, clinical manifestations, etiology, epidemiology, pathogenesis and pathophysiology, prevention, differential diagnosis, diagnostic work-up, prognosis and complications, and management [medlink.com]
Prognosis is correlated closely with the degree of neurologic dysfunction at diagnosis, so early recognition is crucial. [neurospine.wordpress.com]
In general, diabetic lumbosacral radiculoplexus neuropathy, lumbosacral radiculoplexus neuropathy, and postsurgical inflammatory neuropathy have a better prognosis 1. [now.aapmr.org]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Laboratory studies Laboratory studies are ordered based on suspected etiology. [now.aapmr.org]
They have included background information about the historical notes, clinical manifestations, etiology, epidemiology, pathogenesis and pathophysiology, prevention, differential diagnosis, diagnostic work-up, prognosis and complications, and management [medlink.com]
With a systematic approach to the evaluation of these disorders, approximately 75% of patients have a specific etiologic diagnosis. [clevelandclinicmeded.com]
Epidemiology
They have included background information about the historical notes, clinical manifestations, etiology, epidemiology, pathogenesis and pathophysiology, prevention, differential diagnosis, diagnostic work-up, prognosis and complications, and management [medlink.com]
[…] indicus Flexor pollicus longus Differential diagnosis: Other involvement of supraclavicular lower plexus Thoracic outlet syndrome, Neurogenic Pancoast syndrome Neuralgic Amyotrophy 10 Nosology: Also called Parsonage-Turner syndrome Brachial Neuritis Epidemiology [neuromuscular.wustl.edu]
It is closely related to GBS and is considered the chronic counterpart Epidemiology Prevalence amongst populations with diabetes mellitus is generally quoted as 0.8%. [patient.info]
Epidemiology /Etiology Lower back pain is severely common in general population, but lumbar radiculopathy has only been reported with an incidence of 3 to 5%. [3] 5-10% of patients with low back pain have sciatica. the annual prevalence of disc related [physio-pedia.com]
Pathophysiology
[…] though studies on the natural history of this disorder have shown that the majority of patients recover within a few years after the attack without any treatment (although recovery is incomplete in many cases), it is a common practice, based on the pathophysiology [mayoclinic.pure.elsevier.com]
They have included background information about the historical notes, clinical manifestations, etiology, epidemiology, pathogenesis and pathophysiology, prevention, differential diagnosis, diagnostic work-up, prognosis and complications, and management [medlink.com]
[…] and pathophysiologic features. [painspa.co.uk]
Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into pathophysiology and treatment. Muscle Nerve. 2002;4:477–91. CrossRef Google Scholar 30. O’Hare J, Abuaisha F, Geoghegan M. [link.springer.com]
Prevention
In this update, the authors added discussion of the preventive measures that can be considered during spine surgery to lower the risk of lumbar plexus injury. [medlink.com]
Discusses physical agents and therapeutic exercise in the prevention, diagnosis, treatment and rehabilitation of disorders that produce pain, impairment, and disability. [books.google.com]
Your doctor may recommend physical therapy to keep your joints and muscles working properly, maintain range of motion, and prevent stiff joints. [mayoclinic.org]
Treatment is aimed at providing pain relief and preventing neurologic deficits in addition to appropriate directed therapy based on the underlying cause. [neurospine.wordpress.com]