Olsen N K, Wermuth L
Ugeskr Laeger. 1989 Jun 19;151(25):1606-9.
Irradiation neuropathy is a term for the damage to peripheral nerve tissue due to irradiation. Brachial irradiation plexopathy is irradiation neuropathy affecting the brachial plexus. This is most frequently a complication of irradiation therapy for cancer of the breast. The incidence varies considerably and is lowest with low total doses of irradiation and limited fractions. The latent period varies from months to several years. The neurological manifestations are paraesthesiae in the fingers, pain, hypaesthesia, hypalgesia, disaesthesia, paresis, hyporeflexia, muscular atrophy and possibly vegetative disturbances. Horner's syndrome may occur. Lymphoedema is observed in approximately on third of the patients. The course of brachial irradiation plexopathy is progressive. No specific treatment is available. The diagnosis is based on the case history, clinical picture, electrodiagnosis and CT of the brachial plexus region. The most important differential diagnosis is metastatic infiltration in the brachial plexus. These two conditions are differentiated best by means of CT guided surgical exploration and histological examination of the tissue. The irreversible nature of brachial irradiation plexopathy and its marked resistance to treatment are such that the optimal irradiation hygienic rules must be observed.
放射性神经病是指由于辐射导致周围神经组织受损的一种病症。臂丛放射性神经病是指影响臂丛神经的放射性神经病。这最常见于乳腺癌放射治疗的并发症。其发病率差异很大，在总辐射剂量低且分次照射有限的情况下发病率最低。潜伏期从数月到数年不等。神经学表现包括手指感觉异常、疼痛、感觉减退、痛觉减退、感觉障碍、轻瘫、反射减退、肌肉萎缩以及可能出现的自主神经功能紊乱。霍纳综合征可能会出现。约三分之一的患者会出现淋巴水肿。臂丛放射性神经病的病程呈进行性。目前尚无特效治疗方法。诊断基于病史、临床表现、电诊断以及臂丛神经区域的CT检查。最重要的鉴别诊断是臂丛神经的转移性浸润。这两种情况通过CT引导下的手术探查和组织的组织学检查能得到最佳鉴别。臂丛放射性神经病的不可逆性及其对治疗的明显抵抗性使得必须遵守最佳的放射卫生规则。
