Difference between cervical radiculopathy and brachial plexopathy

[TMHH]

Hello,

Please anyone can tell me difference between these two?

Thanks, I appreciate your help.


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[typhoonegator]

Well, one affects the roots, and the other affects the plexus. As a result, they have different clinical manifestations. This is because of science, and as a result there are many books in which you can read about the associated syndromes, which are legion, resulting from injuries to the roots, trunks, divisions, cords, and branches.

Basically, don't get stabbed in the armpit.

 

[TMHH]

Well, one affects the roots, and the other affects the plexus. As a result, they have different clinical manifestations. This is because of science, and as a result there are many books in which you can read about the associated syndromes, which are legion, resulting from injuries to the roots, trunks, divisions, cords, and branches.

Basically, don't get stabbed in the armpit.

Thanks

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[chajjohnson]

Look at a map of the brachial plexus. Realize each section of the brachial plexus carries fibers from multiple spinal cord roots, so an injury to brachial plexus affects more than one dermatome/myotome.

 

[TMHH]

Look at a map of the brachial plexus. Realize each section of the brachial plexus carries fibers from multiple spinal cord roots, so an injury to brachial plexus affects more than one dermatome/myotome.

Thanks a lot!

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[neglect]

Hello,

Please anyone can tell me difference between these two?

Thanks, I appreciate your help.


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Clinically the best way to think about it is that a root lesion will give rise to s/s in one dermatotome and myotome. That's not 100% in the setting of a polyradiculopathy. A plexus lesion will give rise to s/s across multiple dermatomes/myotomes.

The other thing to keep in mind is the sensory neuron lives in the DRG and sends an axon proximal to the spinal cord. So a root lesion will not affect the electrophysiologic response in the distal portion. But a plexus lesion will result in decreased sensory amplitudes on the affected limb. The EMG will show denervation in multiple myotomes.

Careful history, exam, judicious use of tests, you'll get it. The pleasure of neurology is that you can use just a few principles to know so much about a patient.

 

[Outrigger]

So a patient with a weak upper extremity but intact sensation would be more likely to have a radiculopathy?

 

[Thama]

Not really. If the entire extremity is weak but sensation is completely spared then that's more likely to be a central lesion. If there's weakness referable to a single dermatome then that could be from compression of a ventral nerve root without compression of the dorsal root, though in practice that would be difficult.

 

[Outrigger]

And by central lesion then you mean most likely a stroke?

 

[Thama]

I mean anything that can cause a focal lesion in the brain or spinal cord, of which a stroke is among the most common. You aren't giving anywhere near enough relevant clinical information to say more.

 

[SurgeDO]

Who cares. Get an MRI.

 

[neglect]

Who cares. Get an MRI.

Of what?

 

[dodobirddh]

-if SNAPs of affected roots are normal while CMAPs are affected on a nerve conduction study ...suspect root/radicles.
-single myotome dermatome affliction in root
-brachial plexus lesions are usually painful