Secondary

Diabetes mellitus Diphtheria Lyme disease

Sarcoidosis with cranial invasion Guillain-Barre syndrome Human immunodeficiency virus paresthesias and diffuse weakness in the upper extremity. Recurrent stretch injuries to the brachial plexus can result in permanent weakness and atrophy. Also, apical lung tumors with direct extension or compression can cause pain in the upper extremity and hand numbness. Radiation therapy also can result in brachial plexopathies. Idiopathic brachial plexopa-thy (Parsonage-Turner syndrome) often occurs abruptly without any clear precipitating factor, although it can develop after an infection, injection, surgery, or childbirth. It typically begins with an aching sensation in the neck or shoulder and progresses over days to produce weakness, sensory loss, and diminished reflexes. Patients with brachial plexopathy often have considerable pain. Recovery is usually spontaneous but can take weeks to months. Some residual weakness may be present in a few patients.

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