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KMID : 0361420110350060807
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 6 p.807 ~ p.815
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Clinical, Electrophysiological Findings in Adult Patients with Non-traumatic Plexopathies
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Ko Kil-Jun
Sung Duk-Hyun
Kang Min-Jae
Ko Moon-Ju
Do Jong-Gul
Sunwoo Hyuk
Kwon Tae-Gun
Hwang Jung-Min
Park Yoon-Hong
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Abstract
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Objective: To ascertain the etiology of non-traumatic plexopathy and clarify the clinical, electrophysiological characteristics according to its etiology.
Method: We performed a retrospective analysis of 63 non-traumatic plexopathy patients that had been diagnosed by nerve conduction studies (NCS) and needle electromyography (EMG). Clinical, electrophysiological, imaging findings were obtained from medical records.
Results: We identifi ed 36 cases with brachial plexopathy (BP) and 27 cases with lumbosacral plexopathy (LSP). The causes of plexopathy were neoplastic (36.1%), thoracic outlet syndrome (TOS) (25.0%), radiation induced (16.7%), neuralgic amyotrophy (8.3%), perioperative (5.6%), unknown (8.3%) in BP, while neoplastic (59.3%), radiation induced (22.2%), neuralgic amyotrophy (7.4%), psoas muscle abscess (3.7%), and unknown (7.4%) in LSP. In neoplastic plexopathy, pain presented as the fi rst symptom in most patients (82.8%), with the lower trunk of the brachial plexus predominantly involved. In radiation induced plexopathy (RIP), pain was a common initial symptom, but the proportion was smaller (50%), and predominant involvements of bilateral lumbosacral plexus and whole trunk of brachial or lumbosacral plexus were characteristic. Myokymic discharges were noted in 41.7% patients with RIP. Abnormal NCS fi nding in the medial antebrachial cutaneous nerve was the most sensitive to diagnose TOS. Neuralgic amyotrophy of the brachial plexus showed upper trunk involvement in all cases.
Conclusion: By integrating anatomic, pathophysiologic knowledge with detailed clinical assessment and the results of ancillary studies, physicians can make an accurate diagnosis and prognosis.
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KEYWORD
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Brachial plexus neuropathies, Lumbosacral plexus neuropathies, Electrophysiology, Neoplasm, Radiation
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