The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Devon I Rubin - One of the best experts on this subject based on the ideXlab platform.
-
Brachial and lumbosacral plexopathies: A review.
Clinical neurophysiology practice, 2020Co-Authors: Devon I RubinAbstract:Diseases of the brachial and lumbosacral plexus are uncommon and complex. The diagnosis of plexopathies is often challenging for the clinician, both in terms of localizing a patient's symptoms to the plexus as well as determining the etiology. The non-specific clinical features and similar presentations to other root, nerve, and non-neurologic disorders emphasize the importance of a high clinical index of suspicion for a Plexopathy and comprehensive clinical evaluation. Various diagnostic tests, including electrodiagnostic (EDX) studies, neuroimaging (including ultrasound, MRI, or PET), serologic studies, and genetic testing, may be used to confirm a Plexopathy and assist in identifying the underlying etiology. EDX testing plays an important role in confirming a Plexopathy defining the localization, pathophysiology, chronicity, severity, and prognosis. Given the complexity of the plexus anatomy, multiple common and uncommon NCS and an extensive needle examination is often required, and a comprehensive, individualized approach to each patient is necessary. Treatment of plexopathies often focuses on symptomatic management although, depending on the etiology, specific targeted treatments may improve outcome. This article reviews the clinical features, EDX approaches, and evaluation and treatment of brachial and lumbosacral plexopathies.
-
Brachial Plexopathy as a rare presenting manifestation of scorpion envenomation.
Muscle & nerve, 2011Co-Authors: Devon I Rubin, Michael W. VavraAbstract:We report a patient who experienced a rare manifestation of an acute, severe brachial Plexopathy as the initial complication of scorpion (presumed Hemiscorpius lepturus species) envenomation. Features suggesting conduction block, due to either proximal demyelination or ion channel dysfunction, along with axonal loss were seen on serial electrophysiological studies. Possible mechanisms of the brachial Plexopathy include direct compression from tissue edema or a toxic effect on the membrane channels along the nerve.
-
Arteritis and Brachial Plexus Neuropathy as Delayed Complications of Radiation Therapy
Mayo Clinic Proceedings, 2001Co-Authors: Devon I Rubin, Paula J. Schomberg, Roger F.j. Shepherd, Jean M. PannetonAbstract:Radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. Electromyography showed a chronic brachial Plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial Plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.
Dowmu Koh - One of the best experts on this subject based on the ideXlab platform.
-
diffusion weighted mr neurography for the assessment of brachial Plexopathy in oncological practice
Cancer Imaging, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P < 0.001). When assessing brachial Plexopathy, inter-observer agreement was moderate for conventional MRI (kappa = 0.48) but good for conventional MRI with DW-MRN (kappa = 0.62). DW-MRN combined with conventional MRI significantly improved diagnostic accuracy in one observer (P < 0.05) but was similar in the other observer. DW-MRN improved visualization of the brachial plexus. Combining DW-MRN with conventional MRI can improve inter-observer agreement and detection of brachial Plexopathy in symptomatic oncological patients.
-
Diffusion-weighted MR neurography for the assessment of brachial Plexopathy in oncological practice
Cancer Imaging, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:Background To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. Methods 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. Results DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone ( P
-
Diffusion-weighted MR neurography for the assessment of brachial Plexopathy in oncological practice
Cancer imaging : the official publication of the International Cancer Imaging Society, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P
Kyoungeun Kim - One of the best experts on this subject based on the ideXlab platform.
-
characteristic features of hereditary neuropathy with liability to pressure palsy hnpp presenting with brachial Plexopathy in soldiers
Journal of the Neurological Sciences, 2014Co-Authors: Kyoungeun KimAbstract:A brachial plexus lesion is not common in hereditary neuropathy with liability to pressure palsy (HNPP). We report the clinical and electrodiagnostic features of young soldiers with HNPP presenting with brachial Plexopathy. By reviewing 2year medical records from Korean military hospitals, we identified soldiers with brachial plexus lesions. Among them, patients diagnosed with HNPP were determined and clinical and electrophysiological findings were compared between HNPP and non-HNPP patients with a brachial plexus lesion. Thirteen patients (6.8%) were diagnosed with HNPP among 189 patients with a brachial plexus lesion. Push-ups, as either a punishment or an exercise, was the most frequent preceding event in HNPP patients (76.9%), whereas it was rare in non-HNPP patients. The distal motor latency of the median nerve showed the highest sensitivity (90.9%) and specificity (100%) for HNPP in patients with a brachial plexus lesion. In conclusion, HNPP should be suspected in patients with brachial Plexopathy if brachial Plexopathy develops after push-ups or if the distal motor latency of median nerves is prolonged.
Adrian Andreou - One of the best experts on this subject based on the ideXlab platform.
-
diffusion weighted mr neurography for the assessment of brachial Plexopathy in oncological practice
Cancer Imaging, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P < 0.001). When assessing brachial Plexopathy, inter-observer agreement was moderate for conventional MRI (kappa = 0.48) but good for conventional MRI with DW-MRN (kappa = 0.62). DW-MRN combined with conventional MRI significantly improved diagnostic accuracy in one observer (P < 0.05) but was similar in the other observer. DW-MRN improved visualization of the brachial plexus. Combining DW-MRN with conventional MRI can improve inter-observer agreement and detection of brachial Plexopathy in symptomatic oncological patients.
-
Diffusion-weighted MR neurography for the assessment of brachial Plexopathy in oncological practice
Cancer Imaging, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:Background To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. Methods 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. Results DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone ( P
-
Diffusion-weighted MR neurography for the assessment of brachial Plexopathy in oncological practice
Cancer imaging : the official publication of the International Cancer Imaging Society, 2015Co-Authors: Adrian Andreou, Aslam Sohaib, David J Collins, Taro Takahara, Thomas C Kwee, Martin O Leach, David Macvicar, Dowmu KohAbstract:To evaluate diffusion-weighted MR neurography (DW-MRN) for visualizing the brachial plexus and for the assessment of brachial Plexopathy. 40 oncological patients with symptoms of brachial Plexopathy underwent 1.5 T MRI using conventional MR sequences and unidirectional DW-MRN. The images were independently reviewed by two radiologists. Anatomic visualization of the brachial plexus was scored using a 5 point scale on conventional MR sequences and then combined with DW-MRN. A brachial plexus abnormality was also scored using a 5 point scale and inter-observer agreement determined by kappa statistics. Diagnostic accuracy for brachial Plexopathy assessed by conventional MRI alone versus conventional MRI combined with DW-MRN was compared by ROC analysis using reference standards. DW-MRN significantly improved visualization of the brachial plexus compared with conventional MRI alone (P
J A Fiedler - One of the best experts on this subject based on the ideXlab platform.
-
Radiation-induced brachial Plexopathy: MR and clinical findings.
AJNR. American journal of neuroradiology, 1996Co-Authors: Brian C. Bowen, A Verma, A H Brandon, J A FiedlerAbstract:A 54-year-old man had a slowly progressive bilateral brachial Plexopathy 17 months after surgery and radiation therapy for a stage IV supraglottic carcinoma. MR imaging at presentation showed a symmetric pattern of parascalene and interscalene hyperintense signal on T2-weighted images and after contrast enhancement. Although hyperintense signal has been more often associated with recurrent tumor than with delayed radiation injury or fibrosis, the location and pattern of the signal abnormalities suggested a diagnosis of radiation-induced Plexopathy. This diagnosis was confirmed by the relative stability of the neurologic and MR findings 30 months after treatment.