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Late radiation injury to peripheral nerves
Pierre-François Pradat1, Sylvie Delanian
1Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière, Paris, France.
Handbook of Clinical Neurology
|August 13, 2013
Summary
Radiation therapy can cause delayed peripheral neuropathies, affecting nerves and blood vessels. Understanding these radiation-induced nerve injuries is crucial for improving patient quality of life.
Area of Science:
- Neurology
- Oncology
- Radiotherapy
Background:
- Peripheral nerves were historically considered radioresistant.
- Clinical observations reveal radiation-induced peripheral neuropathies, often appearing years after radiotherapy.
- Improved cancer survival rates contribute to the increased recognition of these late complications.
Purpose of the Study:
- To explore the pathophysiology of radiation-induced peripheral neuropathies.
- To highlight the heterogeneity in clinical presentation, electrophysiology, and neuroimaging.
- To discuss diagnostic challenges and potential therapeutic strategies.
Main Methods:
- Review of clinical practice and recent reports on postradiation neuropathies.
- Analysis of pathophysiological mechanisms, including fibrosis and direct nerve/vascular injury.
- Comparison with other neurological conditions for diagnostic clarity.
Main Results:
- Radiation-induced peripheral neuropathies exhibit significant heterogeneity in anatomical sites and clinical features.
- Brachial plexopathy following breast cancer radiotherapy is a common form.
- Radiation-induced lumbosacral radiculoplexopathy can be misdiagnosed as ALS or leptomeningeal metastases.
Conclusions:
- Radiation-induced peripheral neuropathies are a significant clinical challenge with complex pathophysiology.
- Accurate diagnosis requires careful consideration of radiotherapy history and diverse clinical presentations.
- Further research into prevention and treatment is essential to improve patient outcomes and quality of life.
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