EDX Evaluation of the Brachial Plexus-Dr. Jorgensen Case Portion

Dr. Jorgensen Case Portion - EDX Evaluation of the Brachial Plexus

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This document describes a case presentation of a 60-year-old patient with left arm pain and weakness. The patient had a history of osteopenia, breast cancer, and treatments including lumpectomy, chemotherapy, and radiation therapy. The patient's medical history also included a family history of stroke and neuropathy. The physical examination revealed normal cranial nerves, normal muscle strength in the left upper extremity, decreased sensation in certain areas of the hand, and decreased reflexes. Electrodiagnostic studies showed abnormal findings in certain nerve conduction measurements. Based on the clinical and electrodiagnostic findings, the differential diagnosis included central nervous system involvement, peripheral nerve involvement, cervical root involvement, brachial plexus involvement, and brain involvement. The final diagnosis was determined to be a left superior trunk or lateral cord brachial plexopathy due to malignant invasion from breast cancer recurrence in the sentinel lymph node. The document highlights the importance of suspecting plexopathies in patients with a history of cancer or radiation therapy and emphasizes the need for imaging the plexus in such cases. Furthermore, it suggests that sensory amplitudes can be useful in differentiating between different types of plexopathies and that the traditional upper plexus - radiculopathy/lower plexus - cancer rule may no longer be applicable.

Keywords

left arm pain

weakness

breast cancer

chemotherapy

radiation therapy

brachial plexus involvement

nerve conduction measurements

malignant invasion

sentinel lymph node

plexopathies