Sistematik Hastalıklarda Radikülopatiler ve Pleksopatiler
Özet
Bu yazı, sistemik hastalıklarda görülen radikülopati ve pleksopatileri klinik, tanısal ve tedavi yönleriyle incelemektedir. Diyabetik radikülopleksopatiler; servikal, torasik ve lumbo-sakral alt tiplere ayrılarak şiddetli ağrı, güçsüzlük, kilo kaybı ve otonomik disfonksiyon gibi belirtilerle ele alınmaktadır. Nöraljik amiyotrofi, ani başlayan omuz-kol ağrısı ve bunu izleyen fokal/multifokal güçsüzlükle karakterize immün aracılı bir tablo olarak sunulmaktadır. Neoplastik radikülopleksopatiler, malign tümör infiltrasyonları ve leptomeningeal metastazlar bağlamında incelenirken; radyasyonun indüklediği pleksopatiler ile aralarındaki en belirgin farkın neoplastik tutulumda ağrının, radyasyonda ise parestezinin ön planda olması şeklinde belirtilmektedir. Ayrıca tüberküloz, herpes zoster, HIV ve Lyme gibi enfeksiyöz nedenlerin yanı sıra sarkoidoz, ankilozan spondilit, Paget hastalığı, Sjögren sendromu ve postoperatif durumlar gibi diğer inflamatuar ve sistemik süreçlerin sinir kökü ve pleksus üzerindeki etkileri, elektromiyografi (EMG) ve manyetik rezonans görüntüleme (MRG) bulguları ile kombine edilerek aktarılmaktadır.
This text examines radiculopathies and plexopathies observed in systemic diseases in terms of clinical, diagnostic, and therapeutic aspects. Diabetic radiculoplexopathies are divided into cervical, thoracic, and lumbosacral subtypes, and are discussed with symptoms such as severe pain, weakness, weight loss, and autonomic dysfunction. Neuralgic amyotrophy is presented as an immune-mediated condition characterized by sudden-onset shoulder and arm pain followed by focal or multifocal weakness. While neoplastic radiculoplexopathies are investigated in the context of malignant tumor infiltrations and leptomeningeal metastases, the most distinct difference between them and radiation-induced plexopathies is stated as pain being prominent in neoplastic involvement, whereas paresthesia is prominent in radiation. Additionally, the effects of infectious causes such as tuberculosis, herpes zoster, HIV, and Lyme disease, as well as other inflammatory and systemic processes like sarcoidosis, ankylosing spondilitis, Paget's disease, Sjögren's syndrome, and postoperative conditions on nerve roots and plexuses are conveyed by combining them with electromyography (EMG) and magnetic resonance imaging (MRI) findings.
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