Re: unilateral radiculopathy

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Posted by CCF NEURO MD on May 21, 1997 at 22:50:28:

In Reply to: unilateral radiculopathy posted by ousama dabbagh M.D on May 10, 1997 at 00:15:18:

: is it possible to have unilateral radiculitis from an infectious source especially viral "CMV ,EBV"
IF the answer is YES would please provide me with the references.
thanks

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Radiculitis is an inflammation of the nerve root as it leaves the spinal cord. It may involve one nerve root but typically it involves many. Typically there is bilateral weakness but it can also produce unilateral weakness. It commonly produces asymmetric muscle weakness, numbness and loss of reflexes. The muscles involved are those that are innervated by the nerve root. Sensory loss may be patchy and less prominent than the weakness. Pain is common, and tends to be sharp and shooting/radiating. It is diagnosed with EMG/NCS, and by Lumbar puncture (elevated protein and inflammatory cells, or normal). Acute and subacute polyradiculopathies may be seen in diabetes, malignancies, herpes zoster infection, lyme disease, sarcoidosis, CMV and EBV as well as a variety of other infectious processes. Previously one of the most common causes was due to syphylis. I have found a number of references which may be helpful
Behar R, Wiley C, McCutchan JA. CMV polyradiculopathy in acquired immune deficiency syndrome. Neurology. 1987,37:557-61
Baringer JR, Townsend JJ. Herpesvirus infection of the peripheral nervous system In Dyck PJ, Thomas PK, Lamber EH, Peripheral neuropathy. Philideplphi: WB Saunders, 1984: 1941-54
Merchut MP. Gruener G. Segmental zoster paresis of limbs, Electromyography and Cloinical Neurophysiology. 36 (6): 369-75, 1996 Sept.
Schmutzhard E. Mohsenipour I Stanek G. Incidence of nervous system Borrelia Burgdorferi infection in patients with lumboradiculitis syndrome. European Neurology. 33 (2) 149-51, 1993
Burkman KA, Gaines RW Jr. Kashani SR, Smith RD. Herpes Zoster: a consideration in the differential diagnosis of radiculopathy, Archives of Physical Medicine and Rehabilitation. 69(2): 132-4, 1988 Feb
Lecomte F. Mihout B, Neurological manifestations of Lyme disease and treatments, Biomedicine and Pharmocotherapy 43(6) 409-13, 1989.

In addition most neurology text books will have some reference to radiculopathies due to infectious causes.

If you want further expertise, call the Cleveland Clinic's Neuromuscular department 1-800-223-2273, ext 45559 to arrange for a consultation. Let us know if we may be of further assistance.

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