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Plexopathy


Presentation

  • 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]
  • The multifocal infiltration of the nerves or the vasculitis may present as peripheral neuropathy.[omicsonline.org]
  • In contrast to these monophasic presentations, other patients may present with a progressive course.[painspa.co.uk]
Raynaud Phenomenon
  • Preoperative comorbidities included neuropathic stump pain, chronic lumbar back pain, cervical spondylosis, Raynaud phenomenon, vitamin B12 deficiency, and depression.[anesthesiology.pubs.asahq.org]
Pseudotumor
  • Inflammatory pseudotumor of nerve. Am J Surg Pathol 1996 ; 20 : 1212 –18 Parsonage M, Turner J Neuralgic amyotrophy: the shoulder-girdle syndrome. Lancet 1948 ; 1 : 973 –78 Dyck PJ, Chance P, Lebo R, et al. Peripheral neuropathy.[ajnr.org]
Colic
  • Other disorders that may fall under the CECD rubric include neonatal failure to thrive, cystic fibrosis, causalgia, brachial plexopathy, phantom limb pain, infantile colic, glaucoma, dysmenorrhea, neremesis gravidarum, unexplained fetal wastage (repetitive[medical-dictionary.thefreedictionary.com]
Failure to Thrive
  • Other disorders that may fall under the CECD rubric include neonatal failure to thrive, cystic fibrosis, causalgia, brachial plexopathy, phantom limb pain, infantile colic, glaucoma, dysmenorrhea, neremesis gravidarum, unexplained fetal wastage (repetitive[medical-dictionary.thefreedictionary.com]
Cranial Neuropathy
  • Focal or multifocal cranial neuropathies, radiculopathies and plexopathies typically result from tumor infiltration (as our presented case report), Herpes Zoster infection or radiation-induced injury [ 12 ].[omicsonline.org]
Dysmenorrhea
  • Other disorders that may fall under the CECD rubric include neonatal failure to thrive, cystic fibrosis, causalgia, brachial plexopathy, phantom limb pain, infantile colic, glaucoma, dysmenorrhea, neremesis gravidarum, unexplained fetal wastage (repetitive[medical-dictionary.thefreedictionary.com]

Workup

  • 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]

Treatment

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

  • 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]
  • We highlight the case because of the uncommon of their presentation and the importance of diagnosis as to the prognosis for recovery.[omicsonline.org]

Etiology

  • 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]
  • Laboratory studies Laboratory studies are ordered based on suspected etiology.[now.aapmr.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]

Epidemiology

  • 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]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • The pathophysiological mechanisms are not yet fully understood. Diagnosis of radiation myelopathy in women with gynecologic malignancies may increase with the use of concomitant chemo-radiation.[gynoncrp.biomedcentral.com]
  • […] and pathophysiologic features.[painspa.co.uk]

Prevention

  • 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]
  • 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]
  • Physical therapy may help maintain function and prevent joint complications.[appliedradiology.com]
  • Physical therapy is valuable in maintaining function and preventing joint complications [ 1, 2, 6, 8, 15 ].[gynoncrp.biomedcentral.com]

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