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Topic: Sacral plexopathy

	eMedicine - Neoplastic Lumbosacral Plexopathy : Article Excerpt by: Rajesh R Yadav, MD
		Plexopathy is part of the initial presentation of cancer in 15% of patients.
		Bilateral plexopathy occurs in 25% of cases and is usually caused by breast cancer metastases.
		Involvement of the sacral sympathetic nerves is less common (10%).
	www.emedicine.com /pmr/byname/neoplastic-lumbosacral-plexopathy.htm (610 words)

	Plexopathies: Encyclopedia of Neurological Disorders
		Plexopathies are a form of peripheral neuropathy (i.e., a form of damage to peripheral nerves).
		Pain, numbness, tingling, and weakness in the area of the affected neural plexus (including the lumbar, sacral, which is also known as the combined lumbsacral plexi, cervical, brachial, etc.), or in the distal appendage or area of the service by nerve fibers traversing through a particular plexus are symptoms of a potential plexopathy.
		Plexopathies are often initially diagnosed by a careful evaluation of the patient's history and symptoms, but electromyographic examination and nerve conduction studies are often the most accurate means to localize and determine the exact nature and site of the plexopathy.
	health.enotes.com /neurological-disorders-encyclopedia/plexopathies (740 words)

	CME/CE/CPE Pain Articles
		The sacral plexus is formed from the union of the lumbosacral trunk with the ventral rami of the 1st through 4th sacral nerves (Figure 2.
		Femoral and saphenous neuropathies are uncommon pain producing conditions that are often confused with lumbosacral plexopathy and indeed, in lumbosacral plexopathy, the femoral nerve trunk often bears the brunt of the damage.
		Gastric partitioning complicated by peripheral neuropathy with lumbosacral plexopathy.
	www.pain.com /sections/professional/cme_article/articlefull.cfm?id=256 (9753 words)

	Plexopathies
		Brachial plexopathy is a common complication of lung cancer and lymphoma, but it can also be caused by metastasis to the brachial plexus from a remote primary tumor.
		Infiltration of the sacral plexus may produce perineal and perirectal pain, which is exacerbated by sitting and lying prone.
		Similar to patients with brachial plexopathy, patients with diffuse or bilateral lumbosacral plexus involvement may have an epidural extension of tumor, in which case, MRI of the epidural space is also required.
	www.hivpositive.com /f-PainHIV/Pain/LS2.3.4.html (528 words)

	AAPM&R - EMG Case No. 64, cont (Site not responding. Last check: 2007-10-21)
		Lumbosacral plexus injuries are common in patients with sacral and pelvic fractures.
		SI disruption leads to a high incidence of plexopathy as the proximal plexus arising from the L5-S2 nerve roots run in front of the SI joint (7, 8).
		Sacral fractures result in nerve root injury if the fracture passes through a nerve foramen or if the fracture is transverse across the spinal canal (9).
	www.aapmr.org /education/emgcases/emg6403e.htm (847 words)

	Pain management in cancer cervix Palat Gayatri, Biji MS, Rajagopal MR Indian J Palliat Care
		Saphner and colleagues[5] found in a study of 2261 patients that lumbosacral plexopathy caused by retroperitoneal lymph node metastases is the most common neurologic complication in patients with advanced cervical cancer.
		Numbness of the dorsal medial foot and sole with associated weakness of knee flexion, ankle dorsiflexion and inversion is typical of lumbosacral trunk extension.
		Unfortunately, many patients with plexopathy or with distension type or colicky type of visceral pain may not respond well to oral opioids and may need the skilled use of adjuvants or alternate routes of administration of drugs such as epidural analgesia.
	www.jpalliativecare.com /article.asp?issn=0973-1075;year=2005;volume=11;issue=2;spage=64;epage=73;aulast=Palat (4747 words)

	eMedicine - Neoplastic Lumbosacral Plexopathy : Article by Rajesh R Yadav, MD
		Involvement of the lumbosacral trunk is associated with a foot drop and numbness of the dorsum of the foot.
		Other causes of lumbosacral plexopathy to consider are idiopathic in nature, aortic aneurysms, diabetes mellitus, obstetric procedures, trauma, anticoagulation therapy, retroperitoneal hematomas, surgical intervention for mesenteric thrombosis, kidney transplantation, tuberculosis, and intragluteal injections.
		Jaeckle KA: Neurological manifestations of neoplastic and radiation-induced plexopathies.
	www.emedicine.com /pmr/topic90.htm (3526 words)

	Postpartum lumbosacral plexopathy limited to autonomic and perineal manifestations: clinical and electrophysiological ...
		Postpartum lumbosacral plexopathy limited to autonomic and perineal manifestations: clinical and electrophysiological study of 19 patients -- Ismael et al.
		Postpartum lumbosacral plexopathy limited to autonomic and perineal manifestations: clinical and electrophysiological study of 19 patients
		Lumbosacral plexopathy occurring during the third part of pregnancy, intrapartum, or postpartum is reported in the literature
	jnnp.bmjjournals.com /cgi/content/full/68/6/771 (1217 words)

	Pinched Nerve: Encyclopedia of Alternative Medicine
		In the low back region, the nerves that go down the leg may come from the lumbar plexus or the sacral plexus.
		If a nerve is pinched where it is part of a plexus, it may be called a plexopathy.
		If the nerve is pinched farther along its length after it has left the plexus it is called a neuropathy.
	health.enotes.com /alternative-medicine-encyclopedia/pinched-nerve (1986 words)

	Buttock And Lower Extremity Pain
		A sacral plexopathy is certainly a possibility, however, the physical findings are not suggestive of this type of lesion.
		An absent right posterior femoral cutaneous nerve SNAP demonstrates that a lesion is also affecting this nerve which is closely associated with the sciatic nerve for most of its course in the region anterior to the gluteus maximus.
		Demonstrating needle abnormalities in essentially all of the muscles innervated by the sciatic nerve and its divisions is compatible with either a sciatic nerve injury or sacral plexopathy.
	daffodil.uthscsa.edu /faculty/dumitru/emgs/plexopathies/lumbosacral/buttock.html (1267 words)

	Geriatrics & Aging
		Two non-traumatic sources of brachial plexopathies should beconsidered in the aging population and require MRI imaging.Metastatic infiltration of the plexus from breast or lung carcinomapresents with pain in the supraclavicular or axillary region and isaccompanied by sensory and motor deficits in a lower trunkpattern.
		Post-radiation plexopathy occurs months toyears after treatment for breast cancer, lung cancer or lymphoma andresults in progressive paresthesias of median-innervated fingers andweakness of intrinsic hand muscles with variable pain.
		Lumbosacral plexopathies occur less frequently than brachialplexopathies, and trauma is not generally a factor.
	www.geriatricsandaging.com /content/2003/June/0606paresthesias.htm (1948 words)

	NGC - NGC Summary
		Plexopathy is the manifestation of abnormal neurological findings by an anatomically defined network of nerves, which are derived from the ventral rami of a set of spinal nerves.
		Such information is valuable in the diagnosis and management of patients with plexopathy due to neoplastic processes (such as nerve sheath tumors, metastases, direct extension of non-neurogenic primary tumor, and lymphoma) or benign processes (such as aggressive fibromatosis [desmoid tumor] and nodular fasciitis).
		In patients with plexopathy and Horner's syndrome, axial images are useful to demonstrate paraspinal extension of tumor.
	www.guideline.gov /summary/summary.aspx?doc_id=10597&nbr=5539&ss=6&xl=999 (4450 words)

	Continuous Sacral Nerve Root Block in the Management of Neuropathic Cancer Pain -- Vranken et al. 95 (6): 1724 -- ...
		in the sacral plexus is primarily treated by nonsteroidal antiinflammatory
		an ovarian carcinoma infiltrating the sacral plexus causing
		a sacral radiculopathy not reacting sufficiently to pharmacological
	www.anesthesia-analgesia.org /cgi/content/full/95/6/1724 (960 words)

	[No title]
		Intravenous pyelography showed bilateral hydronephrosis and narrowed ureters at the first sacral vertebra level.
		The results suggest the entrapment lumbosacral plexopathy due to surrounding fibrosis after irradiation.
		We speculated the sensorimotor losses caused by entrapment of the lumbosacral plexus.
	www.webshells.com /medsrch/plexhojk.txt (449 words)

	Lumbar Sacral Plexopathy Treatment (Site not responding. Last check: 2007-10-21)
		Most of the spinal cord compression by bone metastasis malignant psoas syndrome lumbar plexopathy sacral Lumbar.
		Lumbar pain was significantly more frequent among the patients had new neurological deficits therapy (hemiplegia and brachial plexopathy) fluid filled sac; locations are almost always in the thoracic or lumbar region although cervical and sacral ones do of seizures (overall prevalence 18%) which usually respond well to treatment
		Blood supply of lumbar & sacral plexus: Branches of the internal iliac artery Clinical: lumbar plexopathy patient education Articles.
	www.dreamstin.info /lumbar-sacral-plexopathy-treatment.htm (149 words)

	Encyclopedia (Site not responding. Last check: 2007-10-21)
		It is painless, and electrophysiology does not reveal the myokymic discharges, or abnormal sensory nerve action potentials of irradiation plexopathy.
		The normal imaging of the lumbo- sacral plexus and cauda equina, and the absence of pain, exclude tumour recurrence.
		After two or more decades, very slowly progressive weakness may affect muscles previously involved by acute paralytic poliomyelitis.
	www.eamg-med.com /members/encyclopedia/24/24_16.shtml (3628 words)

	090
		Conduction times along the lumbar and sacral plexi can be computed by stimulating the plexus from the roots proximal to it, and a peripheral nerve off of that plexus distal to it.
		For the sacral plexus, the roots are stimulated with a needle electrode inserted medially and just caudally to the posterior superior iliac spine and the response recorded from the abductor hallucis.
		The distal stimulation is done by stimulating the sciatic nerve at the sciatic notch and also recording the abductor hallucis.
	www.teleemg.com /old_web/Chapters/jbr090.htm (1181 words)

	Plexopathy \| beating-myeloma.org
		The formal diagnosis for the nerve damage caused by the local radiation to my sacrum (tailbone) in September of 1996 is Radiation-Induced Lumbo-Sacral Plexopathy.
		In Novemeber 2004, I got an EMG test and was re-diagnosed as having radiation-induced lumbosacral plexopathy in addition to the peripheral neuropathy.
		This is a link to a pubmed abstract that documents a case of radiation induced lumbosacral plexopathy.
	beating-myeloma.org /?q=node/71 (315 words)

	PMR :: The Physical Medicine and Rehabilitation Center, P.A.
		Fifty percent involve thoracic roots, with the remainder distributed between cranial, cervical, lumbar, and sacral roots.
		These patients are usually middle aged or elderly, as this condition is often seen in adult onset diabetes mellitus.
		The literature has not been careful with distinguishing diabetic plexopathy, amyotrophy, and radiculopathy.
	www.rehabmed.net /newsletters_pubs/lumbosacral3.html (624 words)

	Subject Index, Right
		Acute cauda equina syndrome from a ruptured aneurysm in the sacral canal [
		Sacral fixation using iliac instrumentation and a variable-angle screw device [
		A brachial plexopathy due to myositis ossificans [
	www.thejns-net.org /si/si_S.html (1624 words)

	Medical Dictionary: Sacral plexopathy - WrongDiagnosis.com - WrongDiagnosis.com
		Sacral plexopathy is listed as a "rare disease" by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH).
		This means that Sacral plexopathy, or a subtype of Sacral plexopathy, affects less than 200,000 people in the US population.
		By using this site you agree to our Terms of Use.
	www.wrongdiagnosis.com /medical/sacral_plexopathy_printer.htm (155 words)

	[P&S Medical Review:Mar:94] Neuralgic Amyotrophy: Presentation of a Case and a Review of the Syndrome
		Monopolar needle electromyography of the left upper extremity demonstrated no spontaneous activity; long duration, excessively polyphasic motor units in the abductor pollicis brevis; and `neurogenic' appearing units in the extensor digitorum communis.
		The findings were consistent with a chronic left brachial plexopathy and right-sided, predominantly motor neuropathy of the median nerve, not localized to the carpal tunnel.
		Lymphocytes from neuralgic amyotrophy patients were also found to proliferate in vitro in the presence of normal human brachial plexus nerve extracts but not in the presence of extracts from the sacral plexus.
	cpmcnet.columbia.edu /news/review/archives/medrev_v1n2_0002.html (3007 words)

	MSU/FAME Community Research Forum :: Print Your Abstract :: (Site not responding. Last check: 2007-10-21)
		Ameeth Vedre, MD Ghassan Bachuwa, MD Background: Lumbosacral plexopathies usually present with diffuse weakness of the affected lower extremity, although a patchy distribution of weakness may occur.
		EMG evaluation showed sacral more than lumbar plexopathy, sub-acute and chronic in nature, moderate in severity.
		In this case it is conceivable that lumbo sacral plexopathy was caused secondary to prolonged/transient ischemic neuropraxia vs. prolonged retractors caused compression.
	msufame.msu.edu /researchforum/admin/submission/printAbstract.php?ID=238 (300 words)

	UMC Neurology
		Electrophysiologic testing (EMG/NCV) is probably of less value, but may show chronic denervation in a particular root or may reveal an unexpected diagnosis (e.g., brachial plexopathy, carpal tunnel syndrome).
		Therefore, most commonly, a LMN syndrome would be found, affecting a lumbar or sacral root.
		A sensitive test for lower lumbar and upper sacral root weakness is heel and toe walking, respectively.
	www.neurology.arizona.edu /Training/c4.html (2880 words)

	Clinical Geriatrics
		Examples include celiac plexopathy from pancreatic cancer resulting in boring midepigastric pain, brachial plexopathy from upper lobe lung cancer (Pancoast's syndrome) or from breast cancer, resulting in diffuse shoulder pain with weakness and numbness in the arm.
		Using this technique, a flexible fiberoptic myeloscope can be introduced into the epidural space via the sacral hiatus.
		A three-dimensional image is obtained, and the myeloscope can be steered toward specific nerve roots for mechanical and chemical neurolysis.18 With the advent of fellowship-trained anesthesiologists specializing exclusively in pain management, these newer technologies will become increasingly available to treat all types of pain more effectively.
	www.hmpcommunications.com /cg/displayArticle.cfm?articleID=cgac1349 (3169 words)

	[No title]
		NCS/EMG is very helpful to pinpoint the exact location of the lesion and to exclude a polyneuropathy, radiculopathy or plexopathy.
		Brachial and Lumbar plexopathies represent a complex anatomical diagnostic challenge.
		The EMG in ulnar nerve lesions can establish the location of the pathological process, document the severity and evaluate for common differential diagnosis which includes lower trunk brachial plexopathy and C8 radiculopathy.
	www.emglaboratory.com /physicians/medical.htm (1352 words)

	Current Concepts Review - Degenerative Lumbar Spinal Stenosis -- SPIVAK 80 (7): 1053 -- Journal of Bone and Joint ...
		The hypertrophy of the left superior articular process of the first sacral vertebra (seen on the oblique image [arrow]) causes it to abut the pedicle of the fifth lumbar vertebra, resulting in additional foraminal stenosis.
		The stenosis is greater on the left side than on the right, and the first sacral nerve roots are compressed.
		He was seen because of a four-week history of pain and numbness in the posterior portion of the left lower extremity.
	www.ejbjs.org /cgi/content/full/80/7/1053?ck=nck (8459 words)

	AAPM&R - Case No. 50, cont
		Although her symptoms could result from more than one lesion, such as lumbosacral and cervical radiculopathy/polyradiculopathy, femoral neuropathy with ulnar neuropathy, or lumbosacral radiculopathy with brachial plexopathy, these would be considered lower on the differential diagnosis, given her neurologic presentation and underlying SLE.
		A vasculitic neuropathy with multiple, asymmetric mononeuropathies (mononeuropathy multiplex) is more commonly observed in such patients.
		Diffuse bone marrow heterogeneity of thoracic, lumbar, and sacral vertebral bodies, and pelvic bones.
	www.aapmr.org /education/archive/emg0104b.htm (728 words)

	Boston Spine Clinics, Chiropractor in Boston
		It is usually unilateral (one sided) and is manifest by pain in the thigh and leg and symptoms and signs of involvement show in the superior gluteal and sciatic nerves.
		It is believed to be due to pressure of the fetal head on the sacral plexi.
		It is a limited plexopathy usually occuring after a difficult vaginal delivery and results also in impaired sensation.
	www.bostonspineclinics.com /pregnancy.php (2539 words)

	Brace Menu
		Thoracolumbosacral Orthosis as shown is a postoperative brace for a lumbar l3 spinal operation.
		Pennsylvania Chiropractors Back Pain Neck Pain Arthritis Headaches such as massage heat taking lumbar sacral plexopathy treatment time to rest a back brace and Ibuprofen.
		Thoracolumbosacral Orthosis as shown is lower lumbar spine defect a postoperative brace for a spinal operation.
	www.coresine.com /menu/brace.htm (537 words)

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