3-2-03. Does cervical radiculopathy complicate brachial plexopathy? An electrophysiological analysis

It is well known that cervical radiculopathy (CR) and neuralgic amyotrophy (NA) show very similar phenotype and sometimes difficult to differentiate each other. In 2015, we reported brachial plexus abnormality on three tesla magnetic resonance neurography (3T-MRN) in patients with CR. The purpose of this study is, to investigate signs of brachial plexus involvement with electrophysiological tests. We underwent retrospective chart review of 24 patients with CR from 2009 to 2014. In all patients, we performed 3T-MRN and nerve conduction study (NCS) to evaluate brachial plexus involvement. Mean age is 58 years old, and male patients dominated. Median disease duration was 60 days. Weakness and intervertebral foraminal stenosis were most frequent in C5 and C6 level. On 3T-MRN, brachial plexus involvement was detected in 70% of patients. Among NCS, Abnormal lateral antebrachial cutaneous nerve amplitude was most frequently detected (45%). Possible explanation for the brachial plexus involvement in patients with CR includes damage to dorsal root ganglion by herniated disc, and secondary immune-mediated mechanism involving brachial plexus, as suggested by van Alfen. We suggest phenotype of CR and NA may significantly overlap and we need to be cautious when making a diagnosis of NA.