A Case of Lumbosacral Radiculoplexus Neuropathy: A Rare Complication of Diabetes Mellitus.

Diabetic lumbosacral radiculoplexus neuropathy, also known as diabetic lumbosacral plexopathy or diabetic amyotrophy, is a rare complication of diabetes mellitus. Due to its varied clinical presentation and wide differential, it may pose a diagnostic quandary in assessing patients with proximal asymmetrical lower limb weakness. We present the case of a 74-year-old female patient with a recent onset of falls and aim to discuss the aetiology, differentials, and treatment modalities in diabetic plexopathy.

Lessons in clinical reasoning - pitfalls, myths, and pearls: a woman brought to a halt.

Objectives: Limitations in human cognition commonly result in clinical reasoning failures that can lead to diagnostic errors. A metacognitive structured reflection on what clinical findings fit and/or do not fit with a diagnosis, as well as how discordance of data can help advance the reasoning process, may reduce such errors.

Case Presentation: A 60-year-old woman with Hashimoto thyroiditis, diabetes, and generalized anxiety disorder presented with diffuse arthralgias and myalgias.

Radiation-Induced Lumbosacral Plexopathy.

Lumbosacral plexopathy (LSP) encompasses a group of disorders affecting post-ganglionic fibers derived from the L1-S4 roots. The differential diagnosis is challenging and includes other neuropathies of medullary, radicular, or peripheral origin. Defining the etiology is equally crucial, as LSP management relies on its cause.

Diabetic lumbosacral plexopathy: an unpredictable clinical entity.

Purpose: Diabetic plexopathy is among the most unusual and disabling complication type 2 diabetic mellitus (T2DM) causing major suffering among affected individuals. The clinical presentation includes asymmetric muscle atrophy, weakness, and pain, typically associated with sudden weight loss. In part due to its rarity, this condition can be easily missed with serious consequences including potentially fatal complications.

Risk factors for lumbosacral radiculoplexus neuropathy.

Introduction/aims: Recently, our group found an association between diabetes mellitus (DM) and lumbosacral radiculoplexus neuropathy (LRPN) in Olmsted County, Minnesota; we found a higher risk (odds ratio [OR], 7.91) for developing LRPN in diabetic compared with nondiabetic patients. However, the influence of other comorbidities and anthropomorphic variables was not studied.

Lumbosacral Radiculoplexus Neuropathy: Neurologic Outcomes and Survival in a Population-Based Study.

Objective: To determine whether patients in the community with lumbosacral radiculoplexus neuropathy (LRPN) have milder neuropathy than referral patients, we characterized the outcomes and survival of population-based compared to referral-based LRPN cohorts.

Background: Previously, we found that the incidence of LRPN is 4.16/100,000/y, a frequency greater than other inflammatory neuropathies.

Lumbosacral plexopathy secondary to discectomy and fixation.

Lumbosacral plexopathy (LSP) is a rare entity characterized by acute onset of pain followed by sensory and motor deficits, reflex changes and muscle atrophy. The diagnosis is based on clinical and EMG findings. LSP can result from pelvic tumors, infections, trauma, abdominopelvic or spinal surgery, radiation, intravenous drug abuse, diabetic neuropathy, vasculitis or maybe idiopathic.

Use of MRI in diabetic lumbosacral radiculoplexus neuropathy: case report and review of the literature.

Diabetic lumbosacral radiculoplexus neuropathy is often confused with radiculopathy in the context of spinal degenerative disc disease including spinal stenosis. Accuracy in diagnosis may prevent unnecessary interventional procedures including selective nerve root blocks or epidural steroid injections or even surgery in selected cases. Our patient with known diabetes and lumbar disc disease presented with acute onset of pain in L5-S1 distribution of the left lower extremity.

Immunotherapy for diabetic amyotrophy.

Background: People with diabetes mellitus (DM) sometimes present with acute or subacute, progressive, asymmetrical pain and weakness of the proximal lower limb muscles. The various names for the condition include diabetic amyotrophy, diabetic lumbosacral radiculoplexus neuropathies, diabetic femoral neuropathy or Bruns-Garland syndrome. Some studies suggest that diabetic amyotrophy may be an immune-mediated inflammatory microvasculitis causing ischaemic damage of the nerves.

Gluteal Necrosis and Lumbosacral Plexopathy in a Diabetic Patient after Renal Transplantation.

A 34-year-old diabetic patient underwent a renal transplant which was complicated by right side lower extremity paresis and numbness with gluteal necrosis. The main reason was ligation of internal iliac artery of the same side as a result of extensive microvascular obstruction due to severe atheromatous plaque. This is a rare complication which is mostly reported in aneurysmal patients after bypass surgery.

Lumbosacral plexopathy.

Purpose Of Review: This article provides an up-to-date review of the clinical features and pathogenesis of different types of lumbosacral plexopathy and a clinical approach to their evaluation and management. Often, the pathologic involvement is not limited to the plexus and also involves the root and nerve levels. These conditions are called lumbosacral radiculoplexus neuropathies.

Immunotherapy for idiopathic lumbosacral plexopathy.

Background: Idiopathic lumbosacral plexopathy (ILSP), also called lumbosacral plexitis or non-diabetic lumbosacral (radiculo)plexus neuropathy is a rare clinical entity. The core features are (sub)acute, severe, asymmetrical leg pain, followed by asymmetrical multifocal weakness and atrophy in the subsequent weeks or months. Sensory symptoms include paresthesias, hypesthesia, allodynia, and autonomic dysfunction.

[Normal tissue tolerance to external beam radiation therapy: peripheral nerves].

Plexopathies and peripheral neuropathies appear progressively and with several years delay after radiotherapy. These lesions are observed principally after three clinical situations: supraclavicular and axillar irradiations for breast cancer, pelvic irradiations for various pathologies and limb irradiations for soft tissue sarcomas. Peripheral nerves and plexus (brachial and lumbosacral) are described as serial structures and are supposed to receive less than a given maximum dose linked to the occurrence of late injury.

Immunotherapy for diabetic amyotrophy.

Background: People with diabetes mellitus (DM) sometimes present with acute or subacute, progressive, asymmetrical pain and weakness of the proximal lower limb muscles. The various names for the condition include diabetic amyotrophy, or diabetic lumbosacral radiculoplexus neuropathies. Some studies suggest that it may be due to immune-mediated inflammatory microvasculitis causing ischaemic damage of the nerves.

Diabetic and non-diabetic lumbosacral radiculoplexus neuropathy.

Background: Lumbosacral radiculoplexus neuropathy (LRPN) originally described in diabetic patients is a distinct clinical condition characterized by debilitating pain, weakness and atrophy most commonly affecting the proximal thigh muscles asymmetrically. The syndrome is usually monophasic and preceded by significant weight loss (at least more than 10 lbs). Though a self-limited condition, recovery is gradual with some residual weakness.