Chronic inflammation associated with rheumatic diseases can also lead to lumbosacral neuropathy with varying clinical presentation. [lecturio.com]

Clinical Presentation The patient typically presents with unilateral weakness, sensory loss, and pain. [boneandspine.com]

CASE SUMMARY A 37-year-old male treated with chemoradiation therapy for nasopharyngeal carcinoma (NPC) 11 years prior (radiation dosage to bilateral neck of 5400cGy), presented with progressive upper extremity numbness and weakness. [appliedradiology.com]

In contrast to these monophasic presentations, other patients may present with a progressive course. [painspa.co.uk]

• Weight Loss

  He reported a 60-lb weight loss in the preceding year. [care.diabetesjournals.org]

  Weight loss is also common in this population. [now.aapmr.org]

  They present with acute progressive pain, weakness and autonomic loss in the proximal legs asymmetrically with weight loss. The disease is self-limited and recovery is the rule. [lecturio.com]

• Disability

  NLP associated with pelvic, abdominal, and retroperitoneal tumors often results in significant pain, sensory disturbance, weakness, and disability. [1] Plexus involvement occurs as a result of tumor extension or invasion and heralds a progressive disease [emedicine.medscape.com]

  Permanent disability. How well you recover from a serious brachial plexus injury depends on a number of factors, including your age and the type, location and severity of the injury. [mayoclinic.org]

  It is difficult to predict the individual recovery trajectory from transverse myelitis; some people have little to no residual disabilities, while others experience relatively severe disabilities that may confine them to a wheelchair. [houstonmethodist.org]

  Although the pain characteristically persists for 1 to 2 weeks, as in idiopathic brachial plexitis, in some patients pain may become a disabling symptom, lasting many months. [painspa.co.uk]

  Discomfort and disability are common. No therapy is uniformly effective in patients with radiation-induced brachial injury. [cancernetwork.com]

• Malaise

  Clinically, pain/neurological symptoms are similar to neoplasm, with symptoms such as fever, malaise, point tenderness, weight loss, and night sweats also being common. [now.aapmr.org]

• Muscle Weakness

  Treatment options involve helping you manage your condition, especially focusing on respiratory muscle weakness, swallowing muscle weakness and back muscle weakness. [houstonmethodist.org]

  It is an idiopathic or inherited form of brachial plexopathy with severe shoulder pain followed by muscle weakness and atrophy. Numbness and weakness occur in the distribution of the brachial plexus. [lecturio.com]

  Signs may include: Deformity of the arm or hand Difficulty moving the shoulder, arm, hand, or fingers Diminished arm reflexes Wasting of the muscles Weakness of hand flexing A detailed history may help determine the cause of the brachial plexopathy. [medlineplus.gov]

  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]

• Shoulder Pain

  […] over a few weeks and right shoulder, extending into the right hand 3 months later. [care.diabetesjournals.org]

  pain, although not infrequently encountered on shoulder MRI. [radsource.us]

  Symptoms may include: Numbness of the shoulder, arm, or hand Shoulder pain Tingling, burning, pain, or abnormal sensations (location depends on the area injured) Weakness of the shoulder, arm, hand, or wrist An exam of the arm, hand and wrist can reveal [medlineplus.gov]

  Symptoms Symptoms may include: Numbness of the shoulder, arm, or hand Shoulder pain Tingling, burning, pain, or abnormal sensations (location depends on the area injured) Weakness of the shoulder, arm, hand, or wrist Exams and Tests An exam of the arm [ufhealth.org]

• Hand Deformity

  […] wrists Some signs of nerve issues may include: arm deformities hand deformities diminished reflexes in the arm muscle wasting, or loss of muscle strength muscle wasting or atrophy (decreased muscle size or strength) an inability to flex the hand and [healthline.com]

• Mononeuropathy

  There was no electrophysiologic evidence on this examination of (1) right ulnar nerve mononeuropathy; (2) bilateral median or superficial radial mononeuropathy, including the left median nerve at or distal to the wrist; (3) left C5-T1 radiculopathy in [medical-dictionary.thefreedictionary.com]

  Mononeuropathy is damage to a single nerve or nerve group, polyneuropathy is damage that affects the peripheral nerves in approximately the same areas on both sides of the body and plexopathy affects the brachial or lumbosacral networks of nerves. [houstonmethodist.org]

  […] common Long thoracic nerve (30% to 40%): Mononeuropathy common Anterior interosseus motor (25%) Distal motor branches: Infraspinatus; usually with multiple lesions Mixed nerves Axillary (15%) Musculocutaneous Other (> 5%) Radial Median Phrenic Lateral [neuromuscular.wustl.edu]

  In mononeuropathy, abnormalities are limited to one nerve, whereas in plexopathy, more than one nerve is involved. [archneurosci.com]

  There is great clinic heterogeneity (plexopathy, mononeuropathy or polyneuropathy), and the literature makes reference only to individual or small series of cases [ 3 ]. [omicsonline.org]

• Neurologic Manifestation

  Neurological manifestations of neoplastic and radiation-induced plexopathies.Semin Neurol.2004;24:385-393. Laughlin RS, Dyck JB. Electrodiagnostic testing in lumbosacral plexopathies.Phys Med Rehabil Clin N Am. 2013;24:93-105. [boneandspine.com]

  Neurologic manifestations of neoplastic and radiation-induced plexopathies. Semin Neurol. 2010; 30 (3):254-62. doi: 10.1055/s-0030-1255219. [PubMed: 20577932 ]. 11. Glantz MJ, Burger PC, Friedman AH, Radtke RA, Massey EW, Schold SJ. [archneurosci.com]

  “Neurological Manifestations of Neoplastic and Radiation-induced Plexopathies.” Seminars in Neurology. (2004): 24.04. Garozzo, D, et al. [now.aapmr.org]

• Polyradiculoneuropathy

  A lower limb and motor predominant neuropathy without pain also occurs in diabetes mellitus and has been shown to be a form of diabetic lumbosacral radiculoplexus neuropathy and not diabetic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP [mayoclinic.pure.elsevier.com]

  The HL can cause autoimmune, inflammatory neuropathies like Guillain Barre syndrome or chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) [ 1, 2 ]. [omicsonline.org]

• Irritability

  It is clinically manifested as meningeal irritation, painful radiculopathy (with both lumbar and thoracic localization). Paresis is usually severe. After alleviation of pain, gradual regression of paresis occurs. [ncbi.nlm.nih.gov]

• Incontinence

  All of them presented with urinary (stress incontinence 14, dysuria five), anorectal (faecal incontinence eight, dyskesia one), or sexual dysfunctions (hypoorgasmia or anorgasmia six) after vaginal delivery. [jnnp.bmj.com]

  […] radiate down your arms and legs and into your abdomen; sensations of numbness, tingling, coldness or burning that can cause the lightest touch to be painful; from weakness to paralysis in your arms and legs; and increased need or difficulty in urination, incontinence [houstonmethodist.org]

  Signs of weakness, paresthesia, or incontinence suggest neuromuscular involvement. Easy bruising, weight loss, or bone pain can be seen in association with neoplasm or other infiltrative disease. [consultant360.com]

  Effectiveness of sacral nerve stimulation in fecal incontinence after multimodal oncologic treatment for pelvic malignancies: A multicenter study with 2-year follow-up. Tech Coloproctol. 2018; 22 (2):97-105. doi: 10.1007/s10151-017-1745-2. [archneurosci.com]

• Urinary Incontinence

  However, faecal and urinary incontinence are well known complications of vaginal delivery. [jnnp.bmj.com]

Workup The clinical diagnosis of NLP is confirmed by magnetic resonance imaging (MRI) or computed tomography (CT) scanning of the affected areas. [emedicine.medscape.com]

Please see Table 2 for the diagnostic workup for lumbosacral plexopathy. [now.aapmr.org]

The diagnosis of RILP is essentially one of exclusion, metastasis or a local tumor progression with secondary nerve involvement usually leads the differential diagnosis, the minimal workup must include cerebrospinal fluid analysis, electromyography, and [gynoncrp.biomedcentral.com]

The diagnosis and treatments of plexopathy are similar to the radiculopathy or neuropathic disorders. [medicalrehabilitationcenterspa.com]

Key points • Radiation injury to the brachial plexus most often occurs after treatment for breast cancer, whereas lumbosacral plexopathy occurs after treatment of a number of primary or metastatic pelvic tumors. • Radiation plexopathy generally presents [medlink.com]

In some cases of brachial plexopathy, no treatment is required and recovery happens on its own. [7] Treatment for lumbosacral plexopathy that is not caused by trauma, but instead from diabetic plexopathy, is directed at controlling the person's blood [en.wikipedia.org]

[…] of the carcinoma, when possible, is the first treatment of choice. [emedicine.medscape.com]

In some cases, no treatment is needed and the problem gets better on its own. Treatment options include any of the following: Medicines to control pain Physical therapy to help maintain muscle strength. [pennstatehershey.adam.com]

Prognosis of brachial plexopathy Prognosis depends on the site of injury. Prognosis is good if there is an isolated injury to the upper trunk. Hornor’s syndrome may occasionally have a good prognosis. [lecturio.com]

Contrary to the literature, motor deficit in the lower limbs was absent and prognosis seemed to be different. Electrophysiological data, available for all the patients, showed proximal plexic lesions. [jnnp.bmj.com]

Early interventions carry a better prognosis 8-10, but this could mean unnecessary surgery in some patients 11. [scielo.br]

[…] 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]

Etiology and Pathophysiology The pathologic basis can vary with the different etiologies: compression, transection, inflammatory, or idiopathic. [unboundmedicine.com]

This can be important for determining etiology. [anesthesiology.pubs.asahq.org]

Etiology of brachial plexopathy Thoracic outlet syndrome (TOS) Thoracic outlet syndrome can be vascular or neurogenic. [lecturio.com]

The underlying etiology and pathology is not clearly known. Clinical findings are asymmetrical leg pain and sensory symptoms followed by weakness and atrophy in the subsequent weeks or months. [insights.ovid.com]

Etiology Lumbar plexopathy can be idiopathic or congenital. In the pediatric age group, the causes of lumbar plexopathy mainly are structural diseases or disorders. [consultant360.com]

Epidemiology Incidence The most common etiology is traumatic. It is the most common peripheral nerve injury seen in athletes. It occurs at a rate as high as 49–61% of collegiate football players. [unboundmedicine.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]

The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg Am 2008;90:1258-1264. [ Links ] 3. Mollberg M, Hagberg H, Bager B, Lilja H, Ladfors L. [scielo.br]

Forceps application although not frequently encountered Radiation Hematoma Vascular lesions Inflammatory/micro vasculitis Diabetic lumbosacral radiculoplexus neuropathy Lumbosacral radiculoplexus neuropathy Postsurgical inflammatory neuropathy Sarcoidosis Epidemiology [now.aapmr.org]

Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery. 1997; 40 :1182–8. [ PubMed ] [ Google Scholar ] 51. Yoshikawa T, Hayashi N, Yamamoto S, Tajiri Y, Yoshioka N, Masumoto T, et al. [ncbi.nlm.nih.gov]

Recent Findings: The pathophysiology of diabetic and nondiabetic lumbosacral radiculoplexus neuropathy has been elucidated; it is ischemic injury due to a perivascular inflammatory process and microvasculitis. [mayoclinic.pure.elsevier.com]

Individuals with prolonged, chronic symptoms will require additional testing and treatment. [2] With brachial plexopathy, surgical decompression may be warranted if the pathophysiology of the disease is causing pressure on the affected nerves. [en.wikipedia.org]

Etiology and Pathophysiology The pathologic basis can vary with the different etiologies: compression, transection, inflammatory, or idiopathic. [unboundmedicine.com]

[…] and pathophysiologic features. [painspa.co.uk]

Prevention : Developing good core strength, doing proper stretching exercises, maintaining a healthy weight and posture, and practicing proper lifting techniques, are some of the ways to prevent nerve compression. [medicalrehabilitationcenterspa.com]

Prevention methods vary depending on the cause of your BPN. Once you’ve been diagnosed with BPN and your doctor determines the cause, he or she can provide you with prevention methods. [healthline.com]

Prevention Although damage to your brachial plexus often can't be prevented, you can take steps to reduce the risk of complications once an injury has occurred: For yourself. [mayoclinic.org]

By preventing the deterioration of the nerve fibers from hyperglycemia, patients may recover significant muscle strength. [8] For radiation-induced plexopathies, treatment options are limited to pain/symptom management and provision of assistive devices [en.wikipedia.org]

See a list of some medical information sources Government agencies Centers for Disease Control and Prevention (CDC) ClinicalTrials.gov Food and Drug Administration (FDA) National Cancer Institute (NCI) National Institutes of Health (NIH) National Library [support.google.com]