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]
Case Presentation A 1 year and 8 months old girl was brought in the outpatient department with a painful right lower limb present since three weeks. The pain made it difficult to sleep at night. There was no previous history of trauma or infection. [austinpublishinggroup.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]
Entire Body System
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Fever
Fever is a common, but not universal, sign. Leukocytosis and elevation of the erythrocyte sedimentation rate are typical and in the presence of fever and back pain, the diagnosis should be straightforward. [neurospine.wordpress.com]
Autoimmune diseases can present with systemic symptoms such as weight loss and fever, along with lumbosacral plexus involvement. [now.aapmr.org]
Neuralgic Amyotrophy 10 Nosology: Also called Parsonage-Turner syndrome Brachial Neuritis Epidemiology Male:Female 2.5:1 Incidence: 1.6 to 3 per 100,000 Clinical Prodromes Antecedent or Associated illness (25% to 50%) Upper respiratory Immunization Dengue fever [neuromuscular.wustl.edu]
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Hodgkin Lymphoma
Risk factors vary based on etiology, they include, but are not limited to the following: Family or personal history of pelvic cancers, Hodgkin Lymphoma, or autoimmune diseases Personal history of pelvic radiation, autoimmune diseases or diabetes mellitus [now.aapmr.org]
Hematological
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Hemophilia A
Retroperitoneal hematomas can be secondary to trauma or non-traumatic bleeding episodes seen in patients with an increased bleeding risk (e.g. hemophilia, anticoagulant use, hematologic malignancy). [now.aapmr.org]
Gastrointestinal
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Pelvic Mass
Pelvic masses or a retroperitoneal hemorrhage may require surgical or medical intervention. Neoplastic or radiation-based plexopathy symptoms may need specific medical management, chemotherapy or possibly surgery. [painspa.co.uk]
Skin
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Anhidrosis
anhidrosis) often in a distal-to-proximal gradient. Some patients complain of excessive sweating confined to the head and neck region. [clevelandclinicmeded.com]
Musculoskeletal
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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]
Slide 27: Case 2: Examination, Continued Additional examination findings include normal balance, gait, but diminished sensation to light touch and pinprick, and cold on the right lateral thigh. [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]
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Low Back Pain
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]
Urogenital
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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]
Pregnant women with pregnancy-related low back and pelvic pain (PLBP) developed significantly higher muscle activity in the rectus femoris, psoas major and external oblique during the ASLR test than pregnant women with no PLBP (de Groot et al. 2008 ). [treningogrehab.no]
Neurologic
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Foot Drop
Evaluation of Foot Drop Definitions: When there is paralysis of the dorsal extensor muscles of the foot and the toes (tibialis anterior, extensor digitorum longus, and extensor hallucis longus), which are innervated by the deep peroneal nerve, foot drop [medschool.lsuhsc.edu]
Lesion in which nerve causes the "foot drop". 12. Describe meralgia paresthetic/ Bernhardt-Roth’s syndrome. 13. What are the main clinical symptoms detected in lesions of genital and coccygeal nerves. [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]
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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]
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Myokymia
Latin: Myokymia facialis G51.8 Other disorders of facial nerve Latin: Disordines nervi facialis alii G51.9 Disorder of facial nerve, unspecified Latin: Disordo nervi facialis, non specificatus G52 Disorders of other cranial nerves Latin: Disordines nervorum [mkb-dijagnoza.blogspot.com]
[…] trigeminal nerve( G50.8 ) 5 Disorder of trigeminal nerve, unspecified( G50.9 ) 6 Facial nerve disorders( G51 ) 7 Bell's palsy( G51.0 ) 8 Geniculate ganglionitis( G51.1 ) 9 Melkersson's syndrome( G51.2 ) 10 Clonic hemifacial spasm( G51.3 ) 11 Facial myokymia [coder.aapc.com]
Radiation-induced lumbosacral plexopathy is typically less painful than infiltrative plexopathy and may be associated with myokymia on EMG. [neupsykey.com]
G651Sequelae of other inflammatory polyneuropathy G652Sequelae of toxic polyneuropathy M3483Systemic sclerosis with polyneuropathy PDX Collection 0589 G510Bell's palsy G511Geniculate ganglionitis G512Melkersson's syndrome G513Clonic hemifacial spasm G514Facial myokymia [cms.gov]
Neurofibraoma 2 : Lung; Breast Onset: Paresthesias Median-innervated hand Clinical features Slowly progressive Infraclavicular lesion Long duration ( 2 to 4 years) Little pain Radiation factors High dose: 44 to 50 Gy Axillary nodes Electrodiagnostic EMG Myokymia [neuromuscular.wustl.edu]
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Limb Weakness
Neoplastic Lumbosacral Plexopathy Like the analogous syndrome affecting the brachial plexus, direct infiltration of the lumbosacral plexus by tumor produces a syndrome of subacute pain and limb weakness. [neupsykey.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]
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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]
Workup
Please see Table 2 for the diagnostic workup for lumbosacral plexopathy. [now.aapmr.org]
Treatment
Offers practical, clinically relevant material for the diagnosis and treatment of musculoskeletal conditions. [books.google.com]
Treatment directed at the cause Corticosteroids, although commonly prescribed, have no proven benefit in plexus disorders. Surgery may be indicated for injuries, hematomas, and benign or metastatic tumors. [merckmanuals.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]
UR - UR - 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 in Neurology SN - 1092- [mayoclinic.pure.elsevier.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]
In general, diabetic lumbosacral radiculoplexus neuropathy, lumbosacral radiculoplexus neuropathy, and postsurgical inflammatory neuropathy have a better prognosis 1. [now.aapmr.org]
Prognosis is correlated closely with the degree of neurologic dysfunction at diagnosis, so early recognition is crucial. [neurospine.wordpress.com]
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
Discusses physical agents and therapeutic exercise in the prevention, diagnosis, treatment and rehabilitation of disorders that produce pain, impairment, and disability. [books.google.com]
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]
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]