Brachial Plexus Injuries

The brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves.

Types

The severity of a brachial plexus injury is determined by the type of damage done to the nerves. The most severe 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 is damaged and which leaves some opportunity for the nerve to slowly recover function. Neuropraxia, or stretch injury, is the mildest type of injury Neuropraxia damages the protective covering of the nerve, which causes problems with nerve signal conduction, but does not always damage the nerve underneath. In infants, brachial plexus injuries may happen during birth if the baby’s shoulder is stretched during passage in the birth canal (Brachial Plexus Birth Injuries).

Signs and Symptoms

Symptoms may include a limp or paralyzed arm; lack of muscle control in the arm, hand, or wrist; and a lack of feeling or sensation 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 any obvious shoulder injury. This syndrome can begin with severe shoulder or arm pain followed by weakness and numbness.

Treatment

Many brachial plexus injuries heal without specific treatment.

Medications

Pain medicine may be needed to reduce pain and allow more use of the arm. With severe traumatic injuries, surgery may be indicated. Corticosteroids are sometimes used to treat inflammation in Parsonage-Turner syndrome but may not necessarily improve outcome.

Therapies

Physical and occupational therapy may be useful in regaining strength and use of the arm and hand.

Expected Outcome

The prognosis for a brachial plexus injury is dependent on the severity of the injury. Patients with stretch injuries have the best potential for recovery of normal arm and hand function. When the nerve is cut or severely torn, recovery is poor, although surgery may improve the outcome. Recovery in Parsonage-Turner syndrome depends on how severely inflammation has damaged the nerve.

Clinical Trials

The NINDS conducts and supports research on injuries to organs and networks within the nervous system, such as the brachial plexus. Much of this research is aimed at finding ways to prevent and treat these disorders.

Select this link to view a list of studies currently seeking patients.