Treatment of Diabetic and Nondiabetic Lumbosacral Radiculoplexus Neuropathy

Pariwat Thaisetthawatkul, P. James, P. James B Dyck

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Lumbosacral radiculoplexus neuropathy (LRPN) is a multifocal, asymmetric, painful neuropathic disorder affecting multiple levels of lumbosacral plexus, nerve roots, and distal nerves that emerge from the plexus. The disorder was first described in diabetic patients (DLRPN) and was later found to occur in nondiabetic patients as well. There have been debates as to the pathogenesis of DLRPN and LRPN. Recent detailed and extensive pathologic studies, however, have shown that the main pathogenesis is inflammation and microvasculitis affecting various components in the peripheral nerves, resulting in ischemic injury to the nerves. Even though studies on the natural history of this disorder have shown that the majority of patients recover within a few years after the attack without any treatment (although recovery is incomplete in many cases), it is a common practice, based on the pathophysiology and case series, to administer immunotherapy. Preliminary data from a controlled clinical trial failed to show significant improvement in outcomes measured by neurologic deficits (as judged by the Neuropathy Impairment Score) but did show improvement in symptoms (pain and positive sensory symptoms). Choices of immunotherapy include corticosteroids, intravenous immunoglobulin, plasma exchange, or a combination. Pain management, physical therapy, and treatment of depression remain mainstays for managing this disorder.

Original languageEnglish (US)
Pages (from-to)95-99
Number of pages5
JournalCurrent Treatment Options in Neurology
Volume12
Issue number2
DOIs
StatePublished - Mar 2010
Externally publishedYes

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Immunotherapy
Lumbosacral Plexus
Plasma Exchange
Intravenous Immunoglobulins
Controlled Clinical Trials
Pain Management
Neurologic Manifestations
Natural History
Peripheral Nerves
Adrenal Cortex Hormones
Therapeutics
Depression
Inflammation
Pain
Wounds and Injuries

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Treatment of Diabetic and Nondiabetic Lumbosacral Radiculoplexus Neuropathy. / Thaisetthawatkul, Pariwat; James, P.; Dyck, P. James B.

In: Current Treatment Options in Neurology, Vol. 12, No. 2, 03.2010, p. 95-99.

Research output: Contribution to journalArticle

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