Cervical and lumbosacral radiculoplexus neuropathies1

There are many causes for brachial and lumbosacral plexopathies including stretch, compression, traumatic, lymphomatous, tumor infiltration, radiation, necrotizing vasculitis, and inflammatory damage, among others. Cervical and lumbosacral radiculoplexus neuropathies (CRPN and LSRPN) refer to inflammatory neurologic disorders affecting predominantly the brachial and lumbosacral plexus, respectively. As cervical and lumbosacral roots, the plexus proper and the peripheral nerves coming from the plexus are often involved; the terms CRPN and LSRPN are used to describe these conditions. These illnesses usually present with abrupt onset of pain, followed by weakness and numbness that has unilateral or asymmetrical bilateral involvement often associated with weight loss. The pathogenesis of CRPN and LSRPN usually is ischemic nerve injury from microvasculitis. The clinical symptoms and signs depend on the anatomy of the plexus involved. The best treatment for the inflammatory plexopathies is unclear due to few controlled trials, but given that the pathogenesis is likely inflammatory/microvasculitis, immunotherapy seems desirable. The prognosis is usually good with most patients having spontaneous improvement or recovery, although residual deficits can occur. In this chapter, we discuss CRPN and LSRPN as well as the other causes of brachial and lumbosacral plexopathies.