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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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Spinal nerves are pivotal conduits in the nervous system, bridging the central nervous system (CNS) with the peripheral nervous system (PNS). These nerves enable a complex communication network between the brain, spinal cord, and the rest of the body, facilitating sensory input, motor output, and autonomic functions.
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Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
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Lumbosacral plexopathy.

P James B Dyck, Pariwat Thaisetthawatkul

    Continuum (Minneapolis, Minn.)
    |October 10, 2014
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    Summary
    This summary is machine-generated.

    Lumbosacral radiculoplexus neuropathies stem from various causes, including inflammation and microvasculitis. Early immunotherapy may benefit patients with these conditions, improving outcomes for lumbosacral plexus disorders.

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    Area of Science:

    • Neurology
    • Pathophysiology
    • Clinical Medicine

    Background:

    • Lumbosacral plexopathy involves the lumbosacral plexus, roots, and nerves, collectively termed lumbosacral radiculoplexus neuropathies.
    • Understanding the diverse etiologies and clinical presentations is crucial for effective management.

    Observation:

    • Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies share similar clinical and neurophysiologic features, including pain, paresthesia, and asymmetric motor weakness.
    • A distinct diabetic neuropathy presents with motor predominance and lacks pain, differing from chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
    • Post-surgical plexopathies can also exhibit inflammatory microvasculitis, suggesting a role for immunotherapy.

    Findings:

    • The pathophysiology involves ischemic injury from perivascular inflammation and microvasculitis in both diabetic and nondiabetic cases.
    • Neoplastic, traumatic, infectious, radiation, and inflammatory processes can all lead to lumbosacral plexopathy.
    • Many previously idiopathic cases are now attributed to microvasculitis-induced ischemic injury.

    Implications:

    • Timely diagnosis and management based on the underlying cause are essential for lumbosacral plexopathy.
    • Immunotherapy is considered in management, even with limited evidence for neurologic deficit improvement, particularly in inflammatory/microvasculitic cases.
    • This review highlights the importance of recognizing microvasculitis as a key pathophysiologic mechanism in lumbosacral radiculoplexus neuropathies.