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Abstract Details

Triggers and Risk Factors in Lumbosacral Radiculoplexus Neuropathy
Neuromuscular and Clinical Neurophysiology (EMG)
P13 - Poster Session 13 (5:30 PM-6:30 PM)
1-004
To investigate the triggers and risk factors for Lumbosacral Radiculoplexus Neuropathy (LRPN).

Recently, our group found significantly higher frequency of diabetes mellitus (DM) in patients with LRPN compared to age-gender matched controls (66.1% vs 19.8%) from Olmsted County, Minnesota, USA. Within the same population, we found diabetics have odds of 7.91 for developing LRPN compared to non-diabetics. However, triggers and the influence of other comorbidities were not studied.

Demographic and clinical data from 59 LRPN patients (62 episodes) and 177 age-gender matched controls were extracted from the Rochester Lumbosacral Radiculoplexus Neuropathy study. Neuropathy triggers were defined as time-related events to the LRPN episode.
Triggers for the development of LRPN were found in 21 episodes (34%): new intensive DM treatment in 8 patients, surgery in 6, intensive exercise/health style change in 5, and combination of surgery and intensive DM treatment in 2 patients. Compared to controls, LRPN patients more frequently had: hypertension (64.4% vs 44.6%;p=0.009), stroke/TIA (13.6% vs 4%; p=0.009), obesity (53.6% vs 36%; p=0.02), dementia (6.8% vs 1.1%; p=0.017), dyslipidemia (66.1% vs 40.7%; p=0.0007), and previous diagnosis of an autoimmune disorder (15.3% vs 6.2%; p=0.031). In a multivariate logistic regression model, that included DM, diagnosis of LRPN was associated with DM (OR 8.36; CI 4.01-17.42), BMI (OR 1.07; CI 1.01-1.13), stroke (OR 4.08; CI 1.18-14.17) and other autoimmune disorders (OR 4.58; CI 1.43-14.65).
LRPN episodes may be associated with a trigger (intensive DM treatment, exercise and surgery) in one third of cases. DM is the strongest LRPN risk factor, and most others (hypertension, renal dysfunction, dyslipidemia, obesity and dementia) are likely secondary to DM. A previous diagnosis of an autoimmune disorder is also an independent risk factor for LRPN. Immune dysfunction, rapid changes in glycemic control and presence of DM are the main inciting factors for the development of LRPN.
Authors/Disclosures
Marcus Vinicius R. Pinto, MD (Mayo Clinic)
PRESENTER 		Dr. Pinto has nothing to disclose.
Peng Soon Ng, MBBS No disclosure on file
Peter J. Dyck, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Dyck has nothing to disclose.
No disclosure on file
Ruple S. Laughlin, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic Rochester) Dr. Laughlin has nothing to disclose.
P. James B. Dyck, MD, FÂ鶹´«Ã½Ó³»­ (Mayo Clinic) Dr. Dyck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Akcea/Ionis.