Brachial Plexus Injury
- Article
- 2021-03-05
The brachial plexus is a network of nerves that carry signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves. Possible symptoms are a limp or paralyzed arm; lack of muscle control in the arm, hand, or wrist; and a lack of sensation or feeling in the arm or hand. Brachial plexus injuries can occur as a result of shoulder trauma, tumors, or inflammation. There is a rare syndrome called Parsonage-Turner syndrome, or brachial plexitis , which causes inflammation of the brachial plexus without obvious shoulder injury. This syndrome can start with severe pain in the shoulder or arm, followed by weakness and numbness. In infants, injuries to the brachial plexus can occur during birth if the baby's shoulder is straightened while passing through the birth canal.
The severity of a brachial plexus injury is determined by the type of nerve damage. The most serious type, avulsion , is caused when the nerve root is severed or cut from the spinal cord. There is also an incomplete form of avulsion in which part of the nerve has been damaged and which gives the nerve some opportunity to slowly return to function. Neuropraxia , or stretch injury , is the mildest type of injury. Neuropraxia damages the protective lining of the nerve, causing problems with the conduction of nerve signals, but not always damaging the underlying nerve.
Therapy
Some brachial plexus injuries can heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment of brachial plexus injuries includes physical therapy and, in some cases, surgery.
Prognosis
The location and type of brachial plexus injury determine the prognosis. With avulsion and fracture injuries there is no possibility of recovery unless the surgical connection is performed in time. The chance of recovery varies for neuroma and neuropraxy injuries. Most people with neuropraxy injuries recover spontaneously with a 90-100% recovery in function.
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