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

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March 11, 2013

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.

For more clinical pearls and other articles of interest to neurology trainees, visit the Neurology Residents & Fellows page. Listen to this week's Neurology Podcast.

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