Radiation-Induced or Metastatic Brachial Plexopathy?

Abstract

Fourteen patients with presumed radiation plexopathy and 11 patients with metastatic involvement of the brachial plexus were studied. In both groups, plexopathy began after a mean interval of six years, the initial symptom usually being sensory. Almost half the patients with radiation damage had no significant pain; metastatic plexopathy characteristically was very painful. Plexus disease was progressive for an average of nine years in the radiation group, but metastatic plexopathy also sometimes progressed for years without distant metastasis. Sensation, muscle power, and stretch reflexes were affected similarly in both groups. All patients with radiation damage were alive as of this study; almost all with metastatic plexopathy were dead. No single clinical symptom or sign permitted distinction between the two groups.