Radiation induced tissue damage is an important but under recognized issue in neurology. Radiation therapy usually induces central nervous system pathology manifesting as “tumor” like lesions.
Less recognized are disorders of the peripheral nervous system, which radiation therapy could also injure. In an upcoming issue of JNNP, Ghosh and Milone report an incidence of ~10% of radiation induced myopathy in a cohort of cancer patients. Interestingly the most common clinical manifestation was head drop, reflecting the area of radiation (neck and upper torso). EMG disclosed myopathic changes in axial muscles (which could be hard to interpret) while myopathy was evident in 50% of muscles on pathology. Of concern, RIM may be delayed as long as 15 years, and consequently a through history is required in all patients presenting with head drop to glean a history of radiation therapy. Clearly, radiation protocols need to be improved to prevent this debilitation side-effect.
Read more at: http://jnnp.bmj.com/content/early/2014/05/16/jnnp-2013-307447.abstract
- Research paper
Clinical and laboratory findings of 21 patients with radiation-induced myopathy