The brachial plexus is a group of peripheral nerves and nerve fibers extending from the spine into bunches controlling the neck, armpit and arm. The brachial plexus is responsible for muscle control for the majority of the upper limbs. Lesions and brachial plexus injury can lead to severe physical and functional impairment.
Brachial plexus injury can be caused by a number of things, but the most common are shoulder trauma, tumors or inflammation of the nerve area. They are usually classified in one of two ways: traumatic or obstetric.
Traumatic Brachial Plexus Injuries
These can occur as the result of a number of reasons, including:
- high falls where the body lands on its side and shoulder
- violence or gunshot wounds
- traction on the arm
- motor vehicle accidents
- attempts to reduce shoulder dislocation
In all cases, traumatic injuries are caused by a violent stretching of the brachial plexus.
Obstetric Injuries
These usually occur from mechanical injury involving shoulder trauma during a difficult childbirth.
Although injuries to the brachial plexus can occur at any time, they are most common during birth because a baby's shoulders can become impacted or stretched during the process. The excessive stretch results in incomplete sensory and/or motor function of the injured nerve.
Signs and Symptoms of Brachial Plexus Injury
Signs and symptoms of a brachial plexus injury can vary, but most people will experience:
- limp or paralyzed arm
- lack of muscle control in arm, hand, wrist
- lack of feeling or sensation in the arm or hand
Diagnosis of Brachial Plexus Injury
Diagnosis is usually confirmed with an EMG five to seven days following the incident of cause.
Brachial Plexus Injury Treatment
Physical and/or occupational therapy are the most common form of brachial plexus treatment. However, some more severe cases may require surgery. Most infants who are injured during childbirth improve or recover within 6 months, but those that do not most likely will require surgical intervention to repair the injured nerves.