Sign Up for a Free Account
  • Updated 10.17.2023
  • Released 04.26.1996
  • Expires For CME 10.17.2026

Radiation plexopathy



Brachial plexopathy is the most common complication of therapeutic irradiation affecting the peripheral nervous system. Patients treated for breast carcinoma are most often affected; radiation brachial plexopathy is a significant source of morbidity. Lumbosacral plexopathy is also an increasingly recognized complication of radiation therapy for a number of neoplasms. Radiation techniques such as stereotactic body irradiation and intensity-modulated radiotherapy also carry a risk of plexus injury. It is important for neurologists to diagnose radiation-induced plexopathies early and to differentiate them from plexus metastases or other causes of plexopathy. The authors discuss the clinical presentations, diagnostic issues, and management of patients with radiation plexopathies.

Key points

• Radiation injury to the brachial plexus most often occurs after treatment for breast cancer, whereas lumbosacral plexopathy occurs after treatment of a number of primary or metastatic pelvic tumors.

• Radiation plexopathy generally presents with painless numbness and sensory symptoms in the affected limb, with variable weakness. Pain may occur but is usually not early or prominent.

• The most frequent differential diagnosis distinguishes radiation plexopathy from metastases to the brachial or lumbosacral plexus.

• The clinical course of radiation plexopathy is variable, though most patients suffer from progressive sensory and motor deficits. Therapy options are very limited.

Historical note and terminology

The first reports of radiation-induced brachial plexopathy appeared in the early 1960s, shortly after the widespread introduction of modern megavoltage radiotherapy for treatment of breast carcinoma. Radiation brachial plexopathy is the most frequent complication of radiotherapy affecting the peripheral nervous system. Lumbosacral plexopathy is less common and has been clearly recognized only during the past 20 years.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660



ISSN: 2831-9125