E-Pearl of the Week: Brachial Plexopathy: Is it metastatic disease or radiation-induced?

March 11, 2013

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March 11, 2013

Brachial Plexopathy: Is it metastatic disease or radiation–induced?

Upper extremity weakness and sensory changes are a common consult for many neurologists. In patients with a known history of cancer, determining whether a plexopathy is secondary to metastatic disease versus radiation can have implications on treatment and prognosis. Metastatic plexopathy often presents with severe pain and more often invades the C8–T1 nerve roots, or lower trunk, because of the proximity of axillary lymph nodes. Lung and breast cancer are common malignancies associated with metastatic plexopathy. Radiation-induced plexopathy often affects the upper trunk and corresponding musculature. It is usually less painful and associated with localized edema.

References

1. Jaeckle KA. Neurologic Manifestations of Neoplastic and Radiation-Induced Plexopathies. Semin Neurol 2010;3: 254–262.

Submitted by: James Addington, M.D. Resident Physician, University of Virginia

Disclosure: Dr. Addington reports no disclosures.

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