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Brachial and lumbar neuropathies
1Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.
Bailliere'S Clinical Neurology
|April 1, 1994
Summary
Acute brachial plexus neuropathy, though rare, can be triggered by various factors and often resolves well. Lumbosacral plexus neuropathy is less common and recovery is less certain, with autoimmune responses implicated in some cases.
Area of Science:
- Neurology
- Immunology
Background:
- Acute brachial plexus neuropathy affects approximately 1.64/100,000 individuals, with lumbosacral involvement being rarer.
- Plexopathies can arise post-treatment, suggesting autoimmune or inflammatory mechanisms.
- Vaccines, infections, and medications are potential triggers for these neuropathies.
Purpose of the Study:
- To investigate the autoimmune response in acute brachial plexus neuropathy.
- To differentiate brachial plexus neuropathy from other conditions like diabetes.
- To understand the histological basis and prognosis of brachial and lumbosacral plexus neuropathies.
Main Methods:
- Analysis of patient lymphocytes for blastogenic response to brachial plexus components.
- Review of existing literature on plexopathy triggers, clinical presentation, and treatment.
- Examination of available histological data for brachial plexus neuropathy.
Main Results:
- Patient lymphocytes showed a specific blastogenic response to brachial plexus components.
- Brachial plexus neuropathy has a high recovery rate (approx. 90% at 3 years), unlike lumbosacral involvement.
- Inflammation is suggested, but demyelination and axonal atrophy roles remain unclear.
Conclusions:
- An autoimmune basis is suggested for some brachial plexus neuropathies.
- Treatment is primarily supportive, focusing on disability limitation.
- Prognosis varies significantly between brachial and lumbosacral plexus neuropathies, with limited histological data available.