Brachial plexopathy is a nerve injury that affects the arm and is caused by physical trauma. It can cause muscle weakness, impaired sensation, and paralysis. Treatment options range from rest to surgery, and most patients recover fully or near fully. Newborns may require surgery if they do not show signs of recovery.
Brachial plexopathy is an injury to the brachial plexus, an arrangement of nerve fibers that lead from the spine, through the neck and armpit, and into the arm. The brachial plexus nerves carry nerve signals to the skin and muscles of the chest, shoulder, arm, and hand. Brachial plexus injury is usually caused by overstretching or tearing of nerve fibers and presents as impaired muscle control or sensation.
Brachial plexopathy is caused by physical trauma of some kind. In adults, the most common causes are sports injuries, motorcycle or off-road vehicle (ATV) accidents, falls, direct violence, or gunshot wounds or forceful pulling on the arm. Newborns can also suffer from brachial plexopathy, which sometimes results from a difficult or unsuccessful delivery.
There are degrees of severity of the condition, as with any nerve damage. In its mildest form, brachial plexus injury can be a temporary condition that can be treated simply through rest and is fully reversible within months. Other types of injuries may require occupational or physical therapy, and some require surgery. Sometimes, anticonvulsant medications are prescribed to manage any nerve pain. In most cases of brachial plexopathy, the prognosis is good for complete or near complete recovery.
Brachial plexopathy can present with muscle weakness or poor muscle control in the hand or arm. Other possible symptoms include impaired sensation, impaired reflexes, and paralysis of the arm or hand. Brachial plexus injury can cause Erb’s palsy, in which the arm hangs limply by the side of the body, while the forearm is extended with the palm facing up. A person with Erb’s palsy is unable to move the arm to any other position. Another ailment caused by some cases is Klumpke’s palsy, in which the muscles of the forearm and hand are paralyzed, usually resulting in a characteristic claw hand in the patient.
Most children who suffer from brachial plexus injuries recover or get better within six months. Those showing signs of recovery can usually be treated with range-of-motion exercises performed by the parents and a regular examination by a doctor. Newborns who show no signs of recovery typically require surgery.
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