Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis

A muscular man in his early twenties was treated with radiation (7000 cGy in 33 fractions) for nasopharyngeal carcinoma. Seven years later, he presented with gradually progressive painless proximal right arm weakness and paresthesia, mild dysarthria, and a sensation of pharyngeal tightness. A neurol...

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Main Authors: Lemuel E. Gordon-Hackshaw, Nathan A. Seven, Nathan P. Young
Format: Article
Language:English
Published: American College of Physicians 2024-12-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0293
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author Lemuel E. Gordon-Hackshaw
Nathan A. Seven
Nathan P. Young
author_facet Lemuel E. Gordon-Hackshaw
Nathan A. Seven
Nathan P. Young
author_sort Lemuel E. Gordon-Hackshaw
collection DOAJ
description A muscular man in his early twenties was treated with radiation (7000 cGy in 33 fractions) for nasopharyngeal carcinoma. Seven years later, he presented with gradually progressive painless proximal right arm weakness and paresthesia, mild dysarthria, and a sensation of pharyngeal tightness. A neurologic examination demonstrated weakness and atrophy of the tongue and right upper limb with abnormal movements of the tongue. Electromyography demonstrated neurogenic limb abnormalities and tongue myokymia, confirming a diagnosis of radiation neurotoxicity.
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spelling doaj-art-2562822e7daf4cc9973b3f8dccfa759a2025-08-20T03:18:48ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-12-0131210.7326/aimcc.2024.0293Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic DiagnosisLemuel E. Gordon-Hackshaw0Nathan A. Seven1Nathan P. Young21Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota2Department of Neurology, Mayo Clinic, Rochester, Minnesota2Department of Neurology, Mayo Clinic, Rochester, MinnesotaA muscular man in his early twenties was treated with radiation (7000 cGy in 33 fractions) for nasopharyngeal carcinoma. Seven years later, he presented with gradually progressive painless proximal right arm weakness and paresthesia, mild dysarthria, and a sensation of pharyngeal tightness. A neurologic examination demonstrated weakness and atrophy of the tongue and right upper limb with abnormal movements of the tongue. Electromyography demonstrated neurogenic limb abnormalities and tongue myokymia, confirming a diagnosis of radiation neurotoxicity.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0293
spellingShingle Lemuel E. Gordon-Hackshaw
Nathan A. Seven
Nathan P. Young
Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
Annals of Internal Medicine: Clinical Cases
title Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
title_full Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
title_fullStr Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
title_full_unstemmed Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
title_short Postradiation Cranial Brachial Plexus Neuropathy: Clinical Examination and Electrophysiologic Diagnosis
title_sort postradiation cranial brachial plexus neuropathy clinical examination and electrophysiologic diagnosis
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0293
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AT nathanaseven postradiationcranialbrachialplexusneuropathyclinicalexaminationandelectrophysiologicdiagnosis
AT nathanpyoung postradiationcranialbrachialplexusneuropathyclinicalexaminationandelectrophysiologicdiagnosis