Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy

The lecture is dedicated to the topical problem of neurology — differential diagnosis between cervical radiculopathy and brachial plexopathy. The basic principles and steps of clinical diagnostics, possibilities, and stages of electrophysiological diagnosis of the functionality of the cer...

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Main Author: Albina I. Tretiakova
Format: Article
Language:English
Published: Romodanov Neurosurgery Institute 2019-06-01
Series:Ukrainian Neurosurgical Journal
Online Access:https://theunj.org/article/view/155716
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author Albina I. Tretiakova
author_facet Albina I. Tretiakova
author_sort Albina I. Tretiakova
collection DOAJ
description The lecture is dedicated to the topical problem of neurology — differential diagnosis between cervical radiculopathy and brachial plexopathy. The basic principles and steps of clinical diagnostics, possibilities, and stages of electrophysiological diagnosis of the functionality of the cervical root and trunk of the shoulder plexus are considered.The purpose of the first stage of diagnostics is to determine the origin of the pain syndrome: whether it has a neurogenic nature, or is the aftereffect of the damage to the locomotor system. In the case of neurogenic pathology, the task of the second stage is a clear verification of C5, C6, C7, C8, T1 radiculopathy by evaluating the maximum measurements of motor and sensory nerves originating from a particular root. Accordingly, the differential diagnosis of brachial plexopathy, thoracic outlet syndrome, and mononeuropathy of the nerves of the arm is also based on strict observation of the peculiarities of their location.There were analyzed the opportunities of various methods of electrophysiological diagnostics, namely, stimulation and needle electromyography in solving the problems of topical diagnosis are outlined, as well the evidence of using the method of electromyographic paraspinal mapping at the cervical level for the differential diagnosis between plexopathy and radiculopathy. However, it is maintained that the attending physician should establish the nosological diagnosis. The article presents the clinical cases and restrictions of electromyographic diagnostics in the differentiation of controversial issues. The material of the lecture is based on the review of a significant number of neurosurgical, neurological and orthopedic sources; the author also included the results of her own research performed over the past 20 years including those carried out during the neurosurgery follow-up of about 300 patients.
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spelling doaj.art-a3926cbf08be49349f038b9ffcde07c22024-01-21T08:27:07ZengRomodanov Neurosurgery InstituteUkrainian Neurosurgical Journal2663-90842663-90922019-06-01252465310.25305/unj.155716Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathyAlbina I. Tretiakova0https://orcid.org/0000-0002-3638-4339Romodanov Neurosurgery Institute, Kyiv, Ukraine The lecture is dedicated to the topical problem of neurology — differential diagnosis between cervical radiculopathy and brachial plexopathy. The basic principles and steps of clinical diagnostics, possibilities, and stages of electrophysiological diagnosis of the functionality of the cervical root and trunk of the shoulder plexus are considered.The purpose of the first stage of diagnostics is to determine the origin of the pain syndrome: whether it has a neurogenic nature, or is the aftereffect of the damage to the locomotor system. In the case of neurogenic pathology, the task of the second stage is a clear verification of C5, C6, C7, C8, T1 radiculopathy by evaluating the maximum measurements of motor and sensory nerves originating from a particular root. Accordingly, the differential diagnosis of brachial plexopathy, thoracic outlet syndrome, and mononeuropathy of the nerves of the arm is also based on strict observation of the peculiarities of their location.There were analyzed the opportunities of various methods of electrophysiological diagnostics, namely, stimulation and needle electromyography in solving the problems of topical diagnosis are outlined, as well the evidence of using the method of electromyographic paraspinal mapping at the cervical level for the differential diagnosis between plexopathy and radiculopathy. However, it is maintained that the attending physician should establish the nosological diagnosis. The article presents the clinical cases and restrictions of electromyographic diagnostics in the differentiation of controversial issues. The material of the lecture is based on the review of a significant number of neurosurgical, neurological and orthopedic sources; the author also included the results of her own research performed over the past 20 years including those carried out during the neurosurgery follow-up of about 300 patients.https://theunj.org/article/view/155716
spellingShingle Albina I. Tretiakova
Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
Ukrainian Neurosurgical Journal
title Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
title_full Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
title_fullStr Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
title_full_unstemmed Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
title_short Pain and weakness in hand: Differential diagnosis between cervical radiculopathy and brachial plexopathy
title_sort pain and weakness in hand differential diagnosis between cervical radiculopathy and brachial plexopathy
url https://theunj.org/article/view/155716
work_keys_str_mv AT albinaitretiakova painandweaknessinhanddifferentialdiagnosisbetweencervicalradiculopathyandbrachialplexopathy