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Radiation-induced Plexopathy, Radiculopathy or Myelopathy?

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“The clinical picture is one of progressive motor and sensory loss in the legs, usually appearing within a year after radiation, but sometimes delayed up to several years..”

Plexopathy, Radiculopathy or Myelopathy can all be caused by radiation but that’s as far as I’ve gotten trying to figure out what has happened to my lower body. What little I know about my side-effect from radiation has come from a Facebook group called Radiation-Induced Lumbar Plexopathy.

I recently came across the Pubmed studies linked below and realized that, as they are used in the articles,  the three terms-Plexopathy, Radiculopathy or Myelopathy, seemed almost interchainable. All three pysical disorders are caused by radiation, all three are either considered late stage and all three involve leg weakness and/or numbness. So are all three the same “physical disorder” or are they three different physical disorders?

Hiking poles and ankle-foot orthodics help me walk…

I’m asking mainly because I like to know where I’m going. I like to have an idea of why caused my side effect and what my future will bring. I might be naive but I think I can slow or even eliminate some of my long-term and late stage side effects through diet, supplementation and physical therapy. Thinking I can positively effect my health keeps me focused anyway.

Do you have nerve damage caused by radation? Do any of the symptoms below describe your affliction? Scroll down the page, write a question or comment and I will reply to you ASAP.

Thanks.

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


Lumbo-sacral radiculopathy induced by radiation.

Two patients had lumbo-sacral radiculopathy following radiation treatment of cancer. Twenty previously reported cases were similar. The clinical picture is one of progressive motor and sensory loss in the legs, usually appearing within a year after radiation, but sometimes delayed up to several years. Experimental studies quoted indicate greater vulnerability of peripheral nerves to ionizing radiation than has been previously recognized. Lumbo-sacral radiculopathy is readily produced in the experimental animal (rat) and affords an experimental model closely resembling the human cases reported.

[Radiation myelopathy and plexopathy].

Radiation myelopathy (RM) is a relatively rare disorder characterized by white matter lesions of the spinal cord resulting from irradiation. It is divided into two forms by the latent periods: transient RM and delayed RM. The delayed RM develops usually non-transverse myelopathy symptoms such as dissociated sensory disturbance, unilateral leg weakness, and gait disturbance with asymmetric steps. Spinal MRI shows initially cord swelling and long T1/T2 intramedullary lesion with enhancement, then exhibits cord atrophy. Histopathological findings of delayed RM are white matter necrosis, demyelination, venous wall thickening and hyalinization. Glial theory and vascular hypothesis have been proposed to explain its pathophysiology. Several therapies such as adrenocorticosteroid, anticoagulation and hyperbaric oxygen have been tried to this disease with variable benefits. Radiation plexopathy is classified into two major types by the location:
  • radiation-induced brachial plexopathy (BP) and
  • radiation-induced lumbosacral plexopathy (LSP).
The BP initially emerges as arm and shoulder pain, whereas LSP as leg weakness. Myokymia and fasciculations are observed in both types. Electrophysiological study reveals findings of peripheral neuropathy. It is often difficult to distinguish the radiation plexopathy from cancer invasion to the plexus, but MRI is useful to differentiate between these diseases. Pathological findings are
  • small vessel obstruction,
  • thick fibrosis,
  • axonal degeneration and demyelination.
Its pathomechanism is presumed that radiation-induced fibrous tissue compresses the nerve root as well as microvascular obstruction of the nerve. Adrenocorticosteroid and anticoagulation are considered as the strategy for symptomatic relief.”

Plexopathy

Plexopathy is a disorder affecting a network of nerves, blood vessels, or lymph vessels.[1] The region of nerves it affects are at the brachial or lumbosacral plexus. Symptoms include pain, loss of motor control, and sensory deficits…Both plexopathies can also occur as a consequence of radiation therapy,[3] sometimes after 30 or more years have passed, in conditions known as Radiation-induced Brachial Plexopathy (RIBP)[4] and Radiation-induced Lumbosacral Plexopathy (RILP).[5]…”

Radiculopathy

Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly (a neuropathy). This can result in pain (radicular pain), weakness, numbness, or difficulty controlling specific muscles.[1]

In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbarsacral spine can be manifested with symptoms in the foot…”

Myelopathy

Myelopathy describes any neurologic deficit related to the spinal cord.[1] When due to trauma, it is known as (acute) spinal cord injury

Clinical signs and symptoms depend on which spinal cord level (cervical,[5] thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include:

  • upper motor neuron signs—weakness, spasticity, clumsiness, altered tonus, hyperreflexia and pathological reflexes, including Hoffmann’s sign and inverted Plantar reflex(positive Babinski sign);
  • lower motor neuron signs—weakness, clumsiness in the muscle group innervated at the level of spinal cord compromise, muscle atrophy, hyporeflexia, muscle hypotonicity or flaccidity, fasciculations;
  • sensory deficits;
  • bowel/bladder symptoms and sexual dysfunction…”

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