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Lumbosacral polyradiculopathy mimicking distal polyneuropathy
Journal of Clinical Neuromuscular Disease
|December 17, 2008
Summary
Lumbosacral polyradiculopathy (PR) is a significant cause of lower extremity symptoms often mistaken for polyneuropathy (PN). Consider PR in patients with sensory loss, weakness, and hyporeflexia.
Area of Science:
- Neurology
- Electromyography
- Nerve Disorders
Background:
- Distal lower extremity sensory loss, weakness, and hyporeflexia are commonly attributed to polyneuropathy (PN).
- Lumbosacral polyradiculopathy (PR) is a less commonly considered differential diagnosis for these symptoms.
Purpose of the Study:
- To evaluate the prevalence of lumbosacral polyradiculopathy (PR) in patients referred for polyneuropathy (PN) evaluation.
- To determine the relative importance of PR in causing distal lower extremity neurological deficits.
Main Methods:
- Retrospective chart review of 162 patients evaluated for polyneuropathy (PN) in an electromyography (EMG) laboratory.
- Analysis of clinical data, physical examinations, and electrodiagnostic findings.
Main Results:
- Polyneuropathy (PN) was diagnosed in 49% of cases.
- Lumbosacral polyradiculopathy (PR) was diagnosed in 14% of cases alone, and in 8.6% concurrently with PN.
- Asymmetric sensory examination was significantly more common in PR (p <0.002).
- MRI revealed lumbar stenosis in 82% of patients with PR.
Conclusions:
- Lumbosacral polyradiculopathy (PR) is an important consideration in the differential diagnosis of distal lower extremity sensory loss, weakness, and hyporeflexia.
- Diagnostic evaluation should include consideration of PR, particularly when symptoms are asymmetric.
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