eMedicine Specialties > Physical Medicine and Rehabilitation > Plexopathy

Radiation-Induced Brachial Plexopathy: Follow-up

Author: Robert J Kaplan, MD, James E Van Zandt VA Medical Center, Staff Physician, Department of Rehabilitation Medicine
Contributor Information and Disclosures

Updated: Jun 11, 2009

Follow-up

Further Outpatient Care

  • Continue to monitor the neurologic examination findings. If changes occur, consider repeating electromyelography or MRI.
  • Reinforce patient education regarding protection and care of the extremity with lymphedema. If lymphedema worsens, consider the aforementioned therapeutic interventions and perform an MRI to rule out metastatic disease.

Inpatient & Outpatient Medications

  • For pain control - Tricyclic antidepressants or anticonvulsants for lancinating pain

Transfer

  • If there is evidence of neoplastic disease, the patient needs to be enrolled in an appropriate facility for radiation or chemotherapy.

Deterrence

  • Use radiotherapy doses below 60 cGy.

Complications

  • Lymphangitis
  • Cellulitis
  • Complex regional pain syndrome, type 2
  • Glenohumeral joint subluxation
  • Contractures in the involved upper extremity

Prognosis

  • One third of patients experience significant progression of their radiation-induced plexopathy, whereas the remainder of patients demonstrate gradual progression.

Patient Education

  • Educate patients about lowering the risks of infection secondary to the incident associated with upper extremity trauma.

Miscellaneous

Medicolegal Pitfalls

  • Failure to make an accurate diagnosis of radiation-induced brachial plexopathy
 


More on Radiation-Induced Brachial Plexopathy

Overview: Radiation-Induced Brachial Plexopathy
Differential Diagnoses & Workup: Radiation-Induced Brachial Plexopathy
Treatment & Medication: Radiation-Induced Brachial Plexopathy
Follow-up: Radiation-Induced Brachial Plexopathy
References
Further Reading
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References

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Keywords

radiation-induced brachial plexopathy, brachial plexus, plexopathy, brachial plexopathy, radiation therapy, radiation treatment, breast cancer radiation therapy, breast radiation therapy, cancer radiation therapy, irradiation brachial plexopathy,

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Contributor Information and Disclosures

Author

Robert J Kaplan, MD, James E Van Zandt VA Medical Center, Staff Physician, Department of Rehabilitation Medicine
Robert J Kaplan, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Medical Editor

Rajesh R Yadav, MD, Assistant Professor, Section of Physical Medicine and Rehabilitation, MD Anderson Cancer Center, University of Texas at Houston
Rajesh R Yadav, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Robert H Meier III, MD, Director, Amputee Services of America; Active Medical Staff, Presbyterian/St Luke's Hospital, Spalding Rehabilitation Hospital, Select Specialty Hospital; Consulting Staff, Kindred Hospital
Robert H Meier III, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and Association of Academic Physiatrists
Disclosure: Nothing to disclose.

 
 
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