Carcinomatous Plexopathy

Diagnosis:

The diagnosis is confirmed by isolation of the causative neoplasm and electrophysiological and clinical findings

Clinical features:

Painful,
Features of brachial plexopathy or those of lumbosacral plexopathy:

  • Weakness in lower plexus C8, T1 distribution +atrophy
  • Associated with Horner’s syndrome
  • Asymmetric leg weakness, reduced reflexes

Findings on investigations:

NCS/EMG:

  • Denervation (fibrillations and positive sharp waves PSW) in affected muscles (usually lower plexus)
  • Decreased recruitment (Neurogenic recruitment)
  • SNAP Abnormal conduction velocities in ulnar and median or radial nerves is common
  • CMAP Abnormal conduction velocities in ulnar and median or radial nerves is common

MRI brachial plexus, infiltration by cancer or lumboscaral plexus infiltration by cancer
CT: lung cancer, retroperitoneal tumor
Mammography and breast exam: breast cancer

Related articles: